{
  "hospital_name": "Santa Monica UCLA Medical Center and Orthopaedic Hospital",
  "last_updated_on": "2026-03-29",
  "as_of_date": "2026-01-01",
  "version": "3.0.0",
  "location_name": [
    "UCLA Santa Monica Medical Center"
  ],
  "hospital_address": [
    "1250 16th Street, Santa Monica, CA 90404"
  ],
  "license_information": {
    "license_number": "930000049|CA",
    "state": "CA"
  },
  "type_2_npi": [
    "1427055839"
  ],
  "attestation": {
    "attestation": "To the best of its knowledge and belief, this hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date in the file. This hospital has included all payer-specific negotiated charges in dollars that can be expressed as a dollar amount. For payer-specific negotiated charges that cannot be expressed as a dollar amount in the machine-readable file or not knowable in advance, the hospital attests that the payer-specific negotiated charge is based on a contractual algorithm, percentage or formula that precludes the provision of a dollar amount and has provided all necessary information available to the hospital for the public to be able to derive the dollar amount, including, but not limited to, the specific fee schedule or components referenced in such percentage, algorithm or formula.",
    "confirm_attestation": true,
    "attester_name": "Tammy Wallace"
  },
  "standard_charge_information": [{
  "description": "0.9% SODIUM CHLORIDE--CONTROL FOR ATG",
  "drug_information": {
    "unit": 0.1,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "63323018610",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.03,
      "maximum": 200.1,
      "gross_charge": 40.0,
      "discounted_cash": 22.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.12,
          "standard_charge_percentage": 67.8,
          "median_amount": 0.01,
          "10th_percentile": 0.01,
          "90th_percentile": 0.01,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 200.1,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.029944,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 11.724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "median_amount": 0.01,
          "10th_percentile": 0.01,
          "90th_percentile": 6955.0,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 24.0,
          "standard_charge_percentage": 60.0,
          "median_amount": 0.01,
          "10th_percentile": 0.01,
          "90th_percentile": 6955.0,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 23.404,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 23.404,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.2,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11.2,
          "standard_charge_percentage": 28.0,
          "median_amount": 0.01,
          "10th_percentile": 0.01,
          "90th_percentile": 0.01,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.76,
          "standard_charge_percentage": 69.4,
          "median_amount": 0.01,
          "10th_percentile": 0.01,
          "90th_percentile": 0.02,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 33.8,
          "standard_charge_percentage": 84.5,
          "median_amount": 0.01,
          "10th_percentile": 0.01,
          "90th_percentile": 0.02,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25.6,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.2,
          "standard_charge_percentage": 50.5,
          "median_amount": 0.01,
          "10th_percentile": 0.01,
          "90th_percentile": 0.01,
          "count": "14",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.2,
          "standard_charge_percentage": 50.5,
          "median_amount": 0.01,
          "10th_percentile": 0.01,
          "90th_percentile": 0.01,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 22.4,
          "standard_charge_percentage": 56.0,
          "median_amount": 0.01,
          "10th_percentile": 0.01,
          "90th_percentile": 0.01,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.0,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29.008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.2,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.64,
          "standard_charge_percentage": 39.1,
          "median_amount": 0.01,
          "10th_percentile": 0.01,
          "90th_percentile": 4.13,
          "count": "35",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.12,
          "standard_charge_percentage": 32.8,
          "median_amount": 0.01,
          "10th_percentile": 0.01,
          "90th_percentile": 4.13,
          "count": "35",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.16,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.44,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "median_amount": 0.01,
          "10th_percentile": 0.01,
          "90th_percentile": 0.01,
          "count": "37",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.132,
          "standard_charge_percentage": 77.83,
          "median_amount": 0.01,
          "10th_percentile": 0.01,
          "90th_percentile": 0.01,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.544,
          "standard_charge_percentage": 78.86,
          "median_amount": 0.01,
          "10th_percentile": 0.01,
          "90th_percentile": 0.01,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "1 em core session",
  "code_information": [
    {
      "code": "G9873",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 20.0,
      "maximum": 20.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 20.0,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "1 pc ost pou w built-in conv",
  "code_information": [
    {
      "code": "A5057",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 22.28,
      "maximum": 22.28,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 22.276692,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "1 pc ost pouch w filter",
  "code_information": [
    {
      "code": "A5056",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 10.85,
      "maximum": 10.85,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 10.847636,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "12-24hr sealed lead acid",
  "code_information": [
    {
      "code": "K0733",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 5.25,
      "maximum": 28.9,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5.249392,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5.295178,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.9,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "1pc ost pch drain hgh output",
  "code_information": [
    {
      "code": "A4435",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 13.37,
      "maximum": 13.37,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 13.37266,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "1ST HOSP IP/OBS HIGH 75",
  "code_information": [
    {
      "code": "99223",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 80.1,
      "maximum": 80.1,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 80.1,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "1ST HOSP IP/OBS MODERATE 55",
  "code_information": [
    {
      "code": "99222",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 73.2,
      "maximum": 73.2,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 73.2,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "1ST HOSP IP/OBS SF/LOW 40",
  "code_information": [
    {
      "code": "99221",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 34.3,
      "maximum": 34.3,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.3,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "1ST NF CARE HIGH MDM 50",
  "code_information": [
    {
      "code": "99306",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 72.1,
      "maximum": 72.1,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 72.1,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "1ST NF CARE MODERATE MDM 35",
  "code_information": [
    {
      "code": "99305",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 46.9,
      "maximum": 46.9,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.9,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "1ST NF CARE SF/LOW MDM 25",
  "code_information": [
    {
      "code": "99304",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 37.8,
      "maximum": 37.8,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 37.8,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "1ST OPN IMPLT BAT MODULJ SYS",
  "code_information": [
    {
      "code": "64654",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 56651.13,
      "maximum": 162588.74,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 56651.1295,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 135962.7108,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 157810.273428,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 57177.6353,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 67981.3554,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 162588.741665,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 56651.1295,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 56651.1295,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 56651.1295,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 56651.1295,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "1ST PSYC COLLAB CARE MGMT",
  "code_information": [
    {
      "code": "99492",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 117.53,
      "maximum": 375.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 130.6612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 143.71,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 128.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 117.5305,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 313.58688,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 133.64652,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 363.976656,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 131.8756,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 156.79344,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 155.92094,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 117.5305,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 141.26,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 117.5305,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 374.997644,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 129.28355,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 130.6612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 158.666175,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 130.6612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 129.28355,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 130.6612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 130.6612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 117.5305,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "1ST/SBSQ PSYC COLLAB CARE",
  "code_information": [
    {
      "code": "99494",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 57.88,
      "maximum": 57.88,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 57.88,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "2 em core ms mo 10-12 no wl",
  "code_information": [
    {
      "code": "G9877",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 12.0,
      "maximum": 12.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12.0,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "2 em core ms mo 10-12 wl",
  "code_information": [
    {
      "code": "G9879",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 48.0,
      "maximum": 48.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.0,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "2 em core ms mo 7-9 no wl",
  "code_information": [
    {
      "code": "G9876",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 12.0,
      "maximum": 12.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12.0,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "2 em core ms mo 7-9 wl",
  "code_information": [
    {
      "code": "G9878",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 48.0,
      "maximum": 48.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.0,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "2 em ongoing ms mo 13-15 wl",
  "code_information": [
    {
      "code": "G9882",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 40.0,
      "maximum": 40.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 40.0,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "2 em ongoing ms mo 16-18 wl",
  "code_information": [
    {
      "code": "G9883",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 40.0,
      "maximum": 40.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 40.0,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "2 em ongoing ms mo 19-21 wl",
  "code_information": [
    {
      "code": "G9884",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 40.0,
      "maximum": 40.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 40.0,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "2 em ongoing ms mo 22-24 wl",
  "code_information": [
    {
      "code": "G9885",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 40.0,
      "maximum": 40.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 40.0,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "2 pc drainable ost pouch",
  "code_information": [
    {
      "code": "A4413",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 12.79,
      "maximum": 12.79,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 12.79124,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "2019-ncov diagnostic p",
  "code_information": [
    {
      "code": "U0001",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 35.91,
      "maximum": 103.09,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 35.92,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 59.670304,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 53.129272,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 35.92,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 86.208,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 43.104,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 99.1392,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 35.92,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 43.104,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 50.288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 35.92,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 35.91,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 35.92,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 103.0904,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 39.512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 35.92,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.492,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 35.92,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 39.512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 35.92,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 35.92,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 35.92,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "22nf nonsealed leadacid",
  "code_information": [
    {
      "code": "E2360",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 21.49,
      "maximum": 106.53,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 24.702044,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 21.491323,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 106.53,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "22nf sealed leadacid battery",
  "code_information": [
    {
      "code": "E2361",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 22.26,
      "maximum": 128.24,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 22.26008,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 22.718976,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 128.24,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "2d cephal radio image",
  "code_information": [
    {
      "code": "D0702",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 111.88,
      "maximum": 321.24,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.9288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 136.78,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 121.89,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.8763,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 268.62912,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 136.24296,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 311.79444,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 112.969,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 134.31456,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 158.95012,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.8763,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.8763,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 321.235656,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 123.06393,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.9288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 151.033005,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.9288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 123.06393,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.9288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.9288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.8763,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "2d cephalometric image",
  "code_information": [
    {
      "code": "D0340",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 111.88,
      "maximum": 321.24,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.9288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 136.78,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 121.89,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.8763,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 268.62912,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 136.24296,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 311.79444,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 112.969,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 134.31456,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 158.95012,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.8763,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.8763,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 321.235656,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 123.06393,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.9288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 151.033005,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.9288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 123.06393,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.9288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.9288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.8763,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "2d oral/facial photo image",
  "code_information": [
    {
      "code": "D0703",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 111.88,
      "maximum": 321.24,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.9288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 136.78,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 121.89,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.8763,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 268.62912,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 136.24296,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 311.79444,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 112.969,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 134.31456,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 158.95012,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.8763,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.8763,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 321.235656,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 123.06393,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.9288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 151.033005,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.9288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 123.06393,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.9288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.9288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.8763,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "2d tee w or w/o fol w/con,in",
  "code_information": [
    {
      "code": "C8925",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1003.85,
      "maximum": 2893.69,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1008.253,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1227.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1093.79,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1003.8502,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2419.8072,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1200.47412,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2808.64086,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1017.6235,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1209.9036,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1400.55314,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1003.8502,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1003.8502,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2893.68611,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1104.23522,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1008.253,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1355.19777,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1008.253,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1104.23522,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1008.253,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1008.253,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1003.8502,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "2d tte w or w/o fol w/con,co",
  "code_information": [
    {
      "code": "C8923",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1003.85,
      "maximum": 2893.69,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1008.253,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1227.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1093.79,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1003.8502,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2419.8072,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1200.47412,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2808.64086,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1017.6235,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1209.9036,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1400.55314,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1003.8502,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1003.8502,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2893.68611,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1104.23522,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1008.253,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1355.19777,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1008.253,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1104.23522,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1008.253,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1008.253,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1003.8502,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "2VHPV VACCINE 3 DOSE IM",
  "code_information": [
    {
      "code": "90650",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 132.59,
      "maximum": 135.12,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 135.116,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 135.116,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 132.59,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "3-D RADIOTHERAPY PLAN",
  "code_information": [
    {
      "code": "77295",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 429.75,
      "maximum": 5109.24,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1780.2231,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2125.69,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1894.29,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1738.5112,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4272.53544,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2077.49304,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4959.080232,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1796.7682,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2136.26772,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2423.74188,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1738.5112,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 429.75,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1738.5112,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5109.240297,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1912.36232,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1780.2231,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2346.99012,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1780.2231,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1912.36232,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1780.2231,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1780.2231,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1738.5112,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "361 hct/p skin subs, nos",
  "code_information": [
    {
      "code": "Q4433",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 160.06,
      "maximum": 459.36,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 384.1356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 445.861716,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 161.5441,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 192.0678,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 459.362155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "365 d implant glucose sensor",
  "code_information": [
    {
      "code": "G0564",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 3250.5,
      "maximum": 5575.62,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3250.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3250.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4130.0853,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4130.0853,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4543.09383,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5575.615155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4543.09383,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4130.0853,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "3d anat seg imaging preop",
  "code_information": [
    {
      "code": "C8001",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 111.88,
      "maximum": 474.97,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 165.495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 136.78,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 121.89,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 198.7981,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 397.188,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 461.011356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 167.0331,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 198.594,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.8763,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.8763,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 474.97065,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 123.06393,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 165.495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 151.033005,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 165.495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 123.06393,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 165.495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 165.495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 111.8763,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "3d bn img algor drvd fr mri",
  "code_information": [
    {
      "code": "G0566",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 165.5,
      "maximum": 474.97,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 165.495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 198.7981,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 397.188,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 461.011356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 167.0331,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 198.594,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 474.97065,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 165.495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 165.495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 165.495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 165.495,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "3D CNTR SIMULA TRGT LVR LES",
  "code_information": [
    {
      "code": "0944T",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 306.88,
      "maximum": 880.75,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 306.8821,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 375.53,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 334.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 307.1294,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 736.51704,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 854.866392,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 309.7342,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 368.25852,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 307.1294,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 307.1294,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 880.751627,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 337.84234,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 306.8821,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 414.62469,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 306.8821,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 337.84234,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 306.8821,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 306.8821,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 307.1294,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "4 em core sessions",
  "code_information": [
    {
      "code": "G9874",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 40.0,
      "maximum": 40.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 40.0,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "4VHPV VACCINE 3 DOSE IM",
  "code_information": [
    {
      "code": "90649",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 163.24,
      "maximum": 164.72,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 163.2425,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 163.2425,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 164.72,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "5% dextrose in lactated ring",
  "code_information": [
    {
      "code": "S5011",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 4.85,
      "maximum": 4.85,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4.845,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4.845,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "5% dextrose/water",
  "code_information": [
    {
      "code": "J7060",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 4.38,
      "maximum": 6.09,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4.3775,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4.3775,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.09,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "510(k) skin subs, nos",
  "code_information": [
    {
      "code": "Q4432",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 160.06,
      "maximum": 459.36,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 384.1356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 445.861716,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 161.5441,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 192.0678,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 459.362155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "9 em core sessions",
  "code_information": [
    {
      "code": "G9875",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 72.0,
      "maximum": 72.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 72.0,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "ABACAVIR SULFATE 20 MG/ML PO SOLN",
  "drug_information": {
    "unit": 240.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "64980040524",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 54.51,
      "maximum": 196.25,
      "gross_charge": 218.05,
      "discounted_cash": 119.93,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 141.7325,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 147.8379,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 54.5125,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 185.3425,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 185.3425,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 175.988155,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 71.934695,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 63.910455,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 174.44,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 130.83,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 76.3175,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 185.3425,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 163.5375,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 76.3175,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 87.22,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 164.169845,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 164.169845,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 145.30852,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 148.274,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 174.44,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 163.5375,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 61.054,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 76.3175,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 76.3175,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 151.3267,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 184.25225,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 139.552,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 119.9275,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 185.3425,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 185.3425,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 163.5375,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 110.11525,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 110.11525,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 122.108,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 174.44,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 119.9275,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 119.9275,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 87.22,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 141.7325,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 163.5375,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 87.22,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 141.7325,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 174.44,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 196.245,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 158.12986,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 119.9275,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 163.5375,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 163.5375,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 174.44,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 163.5375,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 141.7325,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 163.5375,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 76.3175,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 126.469,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 141.7325,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 141.7325,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 141.7325,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 174.44,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 174.44,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 141.7325,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.25755,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5204,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0922,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 73.2648,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 87.22,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 54.5125,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 172.281305,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 169.708315,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.95423,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 169.708315,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.95423,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.32064,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 151.304895,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.635,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 163.5375,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 141.7325,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 141.7325,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ABACAVIR SULFATE 300 MG PO TABS",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "68084002121",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2.26,
      "maximum": 8.15,
      "gross_charge": 9.05,
      "discounted_cash": 4.98,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.8825,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6.1359,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2625,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.6925,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.6925,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 7.304255,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.985595,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.652555,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 5.43,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 7.24,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.1675,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.6925,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.7875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1675,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.62,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.813745,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.813745,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.03092,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.154,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 7.24,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.7875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.534,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1675,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1675,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6.2807,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 7.64725,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.792,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.9775,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.6925,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7.6925,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.7875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4.57025,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 5.068,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4.57025,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.24,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4.9775,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4.9775,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.62,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.8825,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.7875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.62,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.8825,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.24,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.145,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4.9775,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.56306,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.7875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.7875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.24,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.7875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.8825,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.7875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.1675,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.249,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.8825,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.8825,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.8825,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.24,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.24,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.8825,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.9684,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.53855,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.6562,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0408,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.62,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2625,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.150405,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.043615,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.13683,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.043615,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.13683,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.19744,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.279795,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.335,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.7875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.8825,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.8825,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ABACAVIR SULFATE-LAMIVUDINE 600-300 MG PO TABS",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "65862033530",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.0,
      "maximum": 3.6,
      "gross_charge": 4.0,
      "discounted_cash": 2.2,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.712,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.2284,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.3196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.1724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.4,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.72,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.12,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.776,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.38,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.56,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.24,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.9008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.32,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.564,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.312,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.616,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.344,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ABACAVIR-DOLUTEGRAVIR-LAMIVUD 600-50-300 MG PO TABS",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "49702023113",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 106.03,
      "maximum": 381.69,
      "gross_charge": 424.1,
      "discounted_cash": 233.26,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 275.665,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 287.5398,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 106.025,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 360.485,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 360.485,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 342.29111,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 139.91059,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 124.30371,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 339.28,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 254.46,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 148.435,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 360.485,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 318.075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 148.435,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 169.64,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 319.30489,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 319.30489,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.69% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 290.9326,
          "standard_charge_percentage": 68.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.70% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 318.075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 339.28,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.748,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 148.435,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 148.435,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 294.3254,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 358.3645,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 271.424,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 233.255,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 360.485,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 360.485,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 318.075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 214.1705,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 237.496,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 214.1705,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 339.28,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 233.255,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 233.255,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 169.64,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 275.665,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 318.075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 169.64,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 275.665,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 339.28,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 381.69,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 307.55732,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 233.255,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 318.075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 318.075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 339.28,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 318.075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 275.665,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 318.075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 148.435,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 245.978,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 275.665,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 275.665,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 275.665,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 339.28,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 339.28,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 275.665,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 165.8231,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1048,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.3364,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 142.4976,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 169.64,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 106.025,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 335.08141,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 330.07703,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 334.44526,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 330.07703,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 334.44526,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 290.42368,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 294.28299,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 296.87,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 318.075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 275.665,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 275.665,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ABATACEPT 125 MG/ML SC SOSY",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00003218811",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 43.44,
      "maximum": 3702.31,
      "gross_charge": 3868.66,
      "discounted_cash": 2127.76,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2514.629,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 3702.30762,
          "standard_charge_percentage": 95.7,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3288.361,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3288.361,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3122.395486,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 43.8,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 43.8,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3094.928,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.11,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2321.196,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3288.361,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2901.495,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1354.031,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 107.424,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 51.792,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1547.464,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2912.714114,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2912.714114,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.69% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 2653.90076,
          "standard_charge_percentage": 68.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.70% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3094.928,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2901.495,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1083.2248,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1354.031,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1354.031,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2684.85004,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3269.0177,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 123.5376,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2127.763,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3288.361,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.712,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2901.495,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1953.6733,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2166.4496,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1953.6733,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3094.928,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.424,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 43.44,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 47.16,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2514.629,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2901.495,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1547.464,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2514.629,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 43.44,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3094.928,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3481.794,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 128.4612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2805.552232,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2901.495,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2901.495,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3094.928,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2901.495,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2514.629,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2901.495,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 47.784,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2243.8228,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2514.629,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 58.644,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2514.629,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2514.629,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3094.928,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3094.928,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2514.629,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 47.784,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1512.64606,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1268.92048,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1562.93864,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1299.86976,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1547.464,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3056.628266,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3010.978078,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3050.825276,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 43.44,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3010.978078,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3050.825276,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2649.258368,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2684.463174,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2901.495,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2514.629,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2514.629,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ABATACEPT 125 MG/ML SC SOSY|DISCARDED DRUG NOT ADMINISTERED",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00003218811_2",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 43.44,
      "maximum": 3702.31,
      "gross_charge": 3868.66,
      "discounted_cash": 2127.76,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2514.629,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 3702.30762,
          "standard_charge_percentage": 95.7,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3288.361,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3288.361,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3122.395486,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 43.8,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 43.8,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3094.928,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2321.196,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.11,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3288.361,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2901.495,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1354.031,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 107.424,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 51.792,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1547.464,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2912.714114,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2912.714114,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.69% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 2653.90076,
          "standard_charge_percentage": 68.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.70% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3094.928,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2901.495,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1083.2248,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1354.031,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1354.031,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2684.85004,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3269.0177,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 123.5376,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2127.763,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.712,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3288.361,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2901.495,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1953.6733,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1953.6733,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2166.4496,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3094.928,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.424,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 43.44,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 47.16,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2514.629,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2901.495,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1547.464,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 43.44,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2514.629,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3094.928,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3481.794,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2805.552232,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 128.4612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2901.495,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2901.495,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3094.928,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2901.495,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2514.629,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2901.495,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 47.784,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2243.8228,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2514.629,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 58.644,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2514.629,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2514.629,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3094.928,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3094.928,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2514.629,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 47.784,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1512.64606,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1268.92048,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1562.93864,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1299.86976,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1547.464,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3056.628266,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3010.978078,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3050.825276,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 43.44,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3010.978078,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3050.825276,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2649.258368,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2684.463174,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2708.062,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2901.495,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2514.629,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2514.629,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ABATACEPT 250 MG IV SOLR",
  "drug_information": {
    "unit": 10.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00003218713",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 43.44,
      "maximum": 19878.48,
      "gross_charge": 3973.71,
      "discounted_cash": 2185.54,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2582.9115,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 3802.84047,
          "standard_charge_percentage": 95.7,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3377.6535,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3377.6535,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 19878.484275,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 43.8,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 43.8,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 63.24,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 63.24,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.11,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3377.6535,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2980.2825,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1390.7985,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 107.424,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 51.792,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1589.484,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 2325.017721,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 2325.017721,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.70% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.69% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 2725.96506,
          "standard_charge_percentage": 68.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3178.968,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2980.2825,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1112.6388,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1390.7985,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1390.7985,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2757.75474,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3357.78495,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 123.5376,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2185.5405,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3377.6535,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.712,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2980.2825,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2006.72355,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2006.72355,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2225.2776,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3178.968,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.424,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 43.44,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 47.16,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2582.9115,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2980.2825,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1589.484,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2582.9115,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3178.968,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 43.44,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3576.339,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 128.4612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2881.734492,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2980.2825,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2980.2825,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3178.968,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2980.2825,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2582.9115,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2980.2825,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 47.784,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2304.7518,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2582.9115,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 58.644,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2582.9115,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2582.9115,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3178.968,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3178.968,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2582.9115,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 47.784,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1553.72061,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1303.37688,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1605.37884,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1335.16656,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1589.484,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3139.628271,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3092.738493,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3133.667706,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 43.44,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3092.738493,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3133.667706,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2721.196608,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2757.357369,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2781.597,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2980.2825,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2582.9115,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2582.9115,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "Abciximab injection",
  "code_information": [
    {
      "code": "J0130",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1375.15,
      "maximum": 1375.15,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1375.147,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1375.147,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "ABD PARACENTESIS",
  "code_information": [
    {
      "code": "49082",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1166.53,
      "maximum": 3347.95,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1166.5345,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1456.56,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1298.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1191.2637,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2799.6828,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1359.10944,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3249.558036,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1177.3761,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1399.8414,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1585.62768,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1191.2637,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1191.2637,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3347.954015,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1310.39007,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1166.5345,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1608.205995,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1166.5345,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1310.39007,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1166.5345,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1166.5345,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1191.2637,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABD PARACENTESIS W/IMAGING",
  "code_information": [
    {
      "code": "49083",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1166.53,
      "maximum": 3347.95,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1166.5345,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1456.56,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1298.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1191.2637,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2799.6828,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1359.10944,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3249.558036,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1177.3761,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1399.8414,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1585.62768,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1191.2637,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1191.2637,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3347.954015,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1310.39007,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1166.5345,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1608.205995,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1166.5345,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1310.39007,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1166.5345,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1166.5345,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1191.2637,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Abduct control hip semi-flex",
  "code_information": [
    {
      "code": "L1630",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 77.6,
      "maximum": 345.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 344.998016,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.6,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Abduction bar-straight",
  "code_information": [
    {
      "code": "L2310",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 98.78,
      "maximum": 306.97,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 306.973148,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 98.78,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "ABETA42 & PTAU181 ECLIA CSF",
  "code_information": [
    {
      "code": "0445U",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 260.5,
      "maximum": 747.64,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 432.7426,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 385.30555,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 625.2,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 718.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 312.6,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 747.635,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 286.55,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 351.675,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 286.55,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.5,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABETA42 & TTAU ECLIA CSF",
  "code_information": [
    {
      "code": "0459U",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 260.5,
      "maximum": 747.64,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 432.7426,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 385.30555,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 625.2,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 718.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 312.6,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 747.635,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 286.55,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 351.675,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 286.55,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.5,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Abio mem abio hyd per sq cm",
  "code_information": [
    {
      "code": "Q4356",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 160.06,
      "maximum": 459.36,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 384.1356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 445.861716,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 161.5441,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 192.0678,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 459.362155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Abio xpl abio xpl hy p sq cm",
  "code_information": [
    {
      "code": "Q4355",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 160.06,
      "maximum": 459.36,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 384.1356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 445.861716,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 161.5441,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 192.0678,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 459.362155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABIRATERONE ACETATE 250 MG PO TABS",
  "drug_information": {
    "unit": 4.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "60687079021",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 5.84,
      "maximum": 116.86,
      "gross_charge": 23.36,
      "discounted_cash": 12.85,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.184,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 15.83808,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.84,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19.856,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19.856,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 116.8584,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 7.706464,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6.846816,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 18.688,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.176,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 14.016,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19.856,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17.52,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.176,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.344,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 13.667936,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 13.667936,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.567104,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.8848,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 18.688,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17.52,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.5408,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.176,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.176,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 16.21184,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 19.7392,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.9504,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12.848,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19.856,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19.856,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17.52,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 11.7968,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 11.7968,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 13.0816,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 18.688,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.848,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.848,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.344,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.184,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17.52,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.344,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.184,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 18.688,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 21.024,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.940672,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.848,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17.52,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17.52,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 18.688,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17.52,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.184,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17.52,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.176,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.5488,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.184,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.184,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.184,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 18.688,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 18.688,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.184,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.13376,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.66208,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.43744,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.84896,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.344,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.84,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 18.456736,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 18.181088,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 18.421696,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 18.181088,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 18.421696,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.996928,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.209504,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.352,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17.52,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.184,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.184,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ABL1 GENE",
  "code_information": [
    {
      "code": "81170",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 240.0,
      "maximum": 861.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 300.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 498.36,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 443.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 300.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 720.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 360.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 828.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 300.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 360.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 420.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 300.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 240.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 300.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 861.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 330.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 300.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 405.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 300.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 330.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 300.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 300.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 300.0,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABLATE BONE TUMOR(S) PERQ",
  "code_information": [
    {
      "code": "20982",
      "type": "HCPCS"
    },
    {
      "code": "20983",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 9076.82,
      "maximum": 64722.57,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22551.4185,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9332.7041,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 19989.46,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 11098.26,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 17813.46,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 9890.14,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16348.5815,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9076.8233,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 54123.4044,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22398.48984,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19732.76112,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10726.23144,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 62820.3807,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25997.656056,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22761.0075,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9419.4406,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 27061.7022,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11199.24492,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23021.55464,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12513.93668,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16348.5815,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9076.8233,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16348.5815,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9076.8233,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 64722.571095,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 26784.860767,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 17983.43965,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9984.50563,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22551.4185,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9332.7041,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22070.585025,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12253.711455,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22551.4185,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9332.7041,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 17983.43965,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9984.50563,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22551.4185,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9332.7041,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22551.4185,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9332.7041,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16348.5815,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9076.8233,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABLATE INF TURBINATE SUBMUC",
  "code_information": [
    {
      "code": "30802",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1882.11,
      "maximum": 5727.36,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1995.5957,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2301.27,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2050.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1882.1144,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4789.42968,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2286.53112,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5559.033024,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2014.1424,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2394.71484,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2667.61964,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1882.1144,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1882.1144,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5727.359659,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2070.32584,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1995.5957,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2540.85444,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1995.5957,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2070.32584,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1995.5957,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1995.5957,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1882.1144,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABLATE INF TURBINATE SUPERF",
  "code_information": [
    {
      "code": "30801",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1882.11,
      "maximum": 5727.36,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1995.5957,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2301.27,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2050.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5229.75,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1882.1144,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4789.42968,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2286.53112,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5559.033024,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2014.1424,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2394.71484,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2667.61964,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1882.1144,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1882.1144,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5727.359659,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2070.32584,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1995.5957,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2540.85444,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1995.5957,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2070.32584,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1995.5957,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1995.5957,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1882.1144,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABLATE PULM TUMOR PERQ CRYBL",
  "code_information": [
    {
      "code": "32994",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 13228.5,
      "maximum": 39237.9,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13671.7421,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 16174.53,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 14413.81,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13228.4961,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 32812.18104,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 15433.5696,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38084.701524,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13798.8049,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16406.09052,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18005.8312,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13228.4961,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13228.4961,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 39237.899827,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14551.34571,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13671.7421,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 17858.469735,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13671.7421,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14551.34571,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13671.7421,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13671.7421,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13228.4961,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABLATE PULM TUMOR PERQ RF",
  "code_information": [
    {
      "code": "32998",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 7413.14,
      "maximum": 22315.85,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7775.5581,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 9064.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 8077.38,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7413.1378,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18661.33944,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8651.05164,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21659.990928,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7847.8228,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9330.66972,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10092.89358,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7413.1378,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7413.1378,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22315.851747,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8154.45158,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7775.5581,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10007.73603,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7775.5581,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8154.45158,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7775.5581,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7775.5581,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7413.1378,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABLT B9 BRST TUM PERQ LSR EA",
  "code_information": [
    {
      "code": "0970T",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 4865.48,
      "maximum": 14453.04,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5035.9021,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4865.4832,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12086.16504,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14028.265524,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5082.7049,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6043.08252,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14453.039027,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5035.9021,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5035.9021,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5035.9021,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5035.9021,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABLT MAL BRST TUM PQ LSR UNI",
  "code_information": [
    {
      "code": "0971T",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 4865.48,
      "maximum": 14453.04,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5035.9021,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4865.4832,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12086.16504,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14028.265524,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5082.7049,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6043.08252,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14453.039027,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5035.9021,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5035.9021,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5035.9021,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5035.9021,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABLT TRURL PRST8 TIS TRNSDCR",
  "code_information": [
    {
      "code": "55882",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 16508.17,
      "maximum": 48701.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16968.9901,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20184.6,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 17987.36,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16508.1689,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 40725.57624,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 47269.683444,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 17126.6969,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 20362.78812,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16508.1689,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16508.1689,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48701.001587,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18158.98579,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16968.9901,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22286.028015,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16968.9901,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18158.98579,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16968.9901,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16968.9901,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16508.1689,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABLTJ 1/+THYR NDUL 1LOBE PRQ",
  "code_information": [
    {
      "code": "60660",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2058.68,
      "maximum": 6096.54,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2124.2301,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2517.15,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2243.14,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2058.6769,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5098.15224,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5917.363548,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2143.9723,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2549.07612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2058.6769,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2058.6769,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6096.540387,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2264.54459,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2124.2301,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2779.213815,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2124.2301,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2264.54459,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2124.2301,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2124.2301,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2058.6769,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABLTJ B9 PRST8 TISSUE HIFU",
  "code_information": [
    {
      "code": "0950T",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 11749.43,
      "maximum": 34943.55,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12175.4514,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11749.4288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 29221.08336,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 33916.557804,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12288.6079,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14610.54168,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34943.545518,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12175.4514,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12175.4514,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12175.4514,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12175.4514,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABLTJ B9 THYR NDUL PERQ LASR",
  "code_information": [
    {
      "code": "0673T",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2058.68,
      "maximum": 6096.54,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2124.2301,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2517.15,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2243.14,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2058.6769,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5098.15224,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2430.831,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5917.363548,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2143.9723,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2549.07612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2835.9695,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2058.6769,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2058.6769,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6096.540387,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2264.54459,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2124.2301,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2779.213815,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2124.2301,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2264.54459,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2124.2301,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2124.2301,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2058.6769,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABLTJ IRE LIVER 1+ TUM PERQ",
  "code_information": [
    {
      "code": "47384",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 13671.74,
      "maximum": 39237.9,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13671.7421,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 32812.18104,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38084.701524,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13798.8049,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16406.09052,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 39237.899827,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13671.7421,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13671.7421,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13671.7421,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13671.7421,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABLTJ IRE PRST8 1+ TUM PERQ",
  "code_information": [
    {
      "code": "55877",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 13671.74,
      "maximum": 39237.9,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13671.7421,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 32812.18104,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38084.701524,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13798.8049,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16406.09052,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 39237.899827,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13671.7421,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13671.7421,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13671.7421,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13671.7421,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABLTJ MAL BRST TUM PERQ CRTX",
  "code_information": [
    {
      "code": "0581T",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 4865.48,
      "maximum": 14453.04,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5035.9021,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5949.05,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5301.45,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4865.4832,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12086.16504,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5715.0138,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14028.265524,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5082.7049,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6043.08252,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6667.5161,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4865.4832,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4865.4832,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14453.039027,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5352.03152,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5035.9021,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6568.40232,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5035.9021,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5352.03152,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5035.9021,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5035.9021,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4865.4832,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABLTJ MAL PRST8 TISS HIFU",
  "code_information": [
    {
      "code": "55880",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 11749.43,
      "maximum": 34943.55,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12175.4514,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 14366.06,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 12802.21,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11749.4288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 29221.08336,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13812.20256,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 33916.557804,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12288.6079,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14610.54168,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16114.23632,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11749.4288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11749.4288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34943.545518,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12924.37168,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12175.4514,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 15861.72888,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12175.4514,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12924.37168,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12175.4514,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12175.4514,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11749.4288,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABLTJ PERC UXTR/PERPH NRV",
  "code_information": [
    {
      "code": "0440T",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2481.19,
      "maximum": 7208.09,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2511.5307,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3033.77,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2703.52,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2481.1896,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6027.67368,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2894.85648,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6996.247824,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2534.8724,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3013.83684,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3377.33256,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2481.1896,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2481.1896,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7208.093109,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2729.30856,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2511.5307,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3349.60596,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2511.5307,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2729.30856,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2511.5307,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2511.5307,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2481.1896,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABO GNOTYP ABO 7 EXONS",
  "code_information": [
    {
      "code": "0180U",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 274.83,
      "maximum": 788.76,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 456.547596,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 406.501053,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 659.592,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 329.796,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 758.5308,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 329.796,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 384.762,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 788.7621,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 302.313,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 371.0205,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 302.313,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABO GNOTYP NEXT GNRJ SEQ ABO",
  "code_information": [
    {
      "code": "0221U",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 274.83,
      "maximum": 788.76,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 456.547596,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 406.501053,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 659.592,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 329.796,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 758.5308,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 329.796,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 384.762,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 788.7621,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 302.313,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 371.0205,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 302.313,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABOBOTULINUMTOXINA 300 UNITS IM SOLR",
  "drug_information": {
    "unit": 300.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "15054053006",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 8.53,
      "maximum": 10315.16,
      "gross_charge": 2062.0,
      "discounted_cash": 1134.1,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1340.3,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1398.036,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.79,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1752.7,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1752.7,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 10315.155,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 8.53,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 8.53,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.75,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 8.9845,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 8.9845,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1752.7,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1546.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 721.7,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.096,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.572,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 824.8,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 1206.4762,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 1206.4762,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.69% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 1414.532,
          "standard_charge_percentage": 68.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.70% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 1649.6,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1546.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 577.36,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 721.7,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 721.7,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1431.028,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1742.39,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 24.2604,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.79,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1134.1,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1752.7,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.548,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1546.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1041.31,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1041.31,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 1154.72,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1649.6,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.334,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.63,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12.68,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1340.3,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1546.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 824.8,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1649.6,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.63,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1340.3,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1855.8,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1495.3624,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25.2273,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1546.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1546.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1649.6,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1546.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1340.3,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1546.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9.493,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1195.96,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.79,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1340.3,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.6505,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1340.3,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1340.3,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.79,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1649.6,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1649.6,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1340.3,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9.493,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.79,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 806.242,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 676.336,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 833.048,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 692.832,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 824.8,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.79,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1629.1862,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1604.8546,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1626.0932,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.63,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1604.8546,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1626.0932,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1412.0576,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1430.8218,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1443.4,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1546.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1340.3,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1340.3,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ABOBOTULINUMTOXINA 500 UNITS IM SOLR",
  "drug_information": {
    "unit": 500.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "15054050001",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 8.53,
      "maximum": 17188.59,
      "gross_charge": 3436.0,
      "discounted_cash": 1889.8,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2233.4,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2329.608,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.79,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2920.6,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2920.6,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 17188.59,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 8.53,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 8.53,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 8.9845,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.75,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 8.9845,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2920.6,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2577.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1202.6,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.096,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.572,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1374.4,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 2010.4036,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 2010.4036,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.70% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.69% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 2357.096,
          "standard_charge_percentage": 68.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 2748.8,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2577.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 962.08,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1202.6,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1202.6,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2384.584,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2903.42,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 24.2604,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.79,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1889.8,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.548,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2920.6,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2577.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1735.18,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1735.18,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 1924.16,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2748.8,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.334,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.63,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12.68,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2233.4,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2577.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1374.4,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2233.4,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.63,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2748.8,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3092.4,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25.2273,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2491.7872,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2577.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2577.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2748.8,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2577.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2233.4,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2577.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9.493,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1992.88,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.79,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2233.4,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.6505,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2233.4,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2233.4,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.79,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2748.8,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2748.8,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2233.4,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9.493,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.79,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1343.476,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1127.008,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1388.144,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1154.496,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1374.4,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.79,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2714.7836,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2674.2388,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2709.6296,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.63,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2674.2388,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2709.6296,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2352.9728,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2384.2404,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2405.2,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2577.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2233.4,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2233.4,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ABORTION (MPR)",
  "code_information": [
    {
      "code": "59866",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 386.5,
      "maximum": 1124.85,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 391.9333,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 472.58,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 421.14,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 386.5038,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 940.63992,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 480.98904,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1091.789484,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 395.5759,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 470.31996,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 561.15388,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 386.5038,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 386.5038,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1124.848571,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 425.15418,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 391.9333,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 521.78013,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 391.9333,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 425.15418,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 391.9333,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 391.9333,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 386.5038,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",
  "code_information": [
    {
      "code": "770",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 24994.07,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11905.95,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14232.3238,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12636.0254,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11905.95,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16721.386172,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10560.877588,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11905.95,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 15355.28,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12321.017168,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 24994.072279,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 18777.28,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12518.18,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13770.01,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11905.95,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11905.95,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13770.01,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11905.95,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12518.18,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABORTION WITHOUT D&C",
  "code_information": [
    {
      "code": "779",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 20970.89,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10056.36,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11941.4122,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10602.0626,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10056.36,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14029.821668,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8860.941772,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10056.36,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12883.61,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10337.759792,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 20970.891601,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16379.62,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10919.74,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12011.72,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10056.36,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10056.36,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12011.72,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10056.36,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10919.74,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Above knee cushion socket",
  "code_information": [
    {
      "code": "L5648",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 220.79,
      "maximum": 1312.7,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1312.696852,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 220.79,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Above knee hydracadence",
  "code_information": [
    {
      "code": "L5610",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1572.18,
      "maximum": 4885.87,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4885.871604,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1572.18,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Above knee leather socket",
  "code_information": [
    {
      "code": "L5642",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 134.48,
      "maximum": 1235.32,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1235.318156,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 134.48,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Above knee wood socket",
  "code_information": [
    {
      "code": "L5644",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 134.48,
      "maximum": 1177.64,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1177.641292,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 134.48,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "ABRASION LESION SINGLE",
  "code_information": [
    {
      "code": "15786",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 252.47,
      "maximum": 740.6,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 258.0493,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 308.7,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 275.1,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 252.4682,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 619.31832,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 300.16572,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 718.835376,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 260.4476,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 309.65916,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 350.19334,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 252.4682,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 252.4682,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 740.601491,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 277.71502,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 258.0493,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 340.83207,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 258.0493,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 277.71502,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 258.0493,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 258.0493,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 252.4682,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABSCESS DRAINAGE UNDER X-RAY",
  "code_information": [
    {
      "code": "75989",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 104.52,
      "maximum": 104.52,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 104.52,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Absolv3 per sq cm",
  "code_information": [
    {
      "code": "Q4401",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 160.06,
      "maximum": 459.36,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 384.1356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 445.861716,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 161.5441,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 192.0678,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 459.362155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ABSORBABLE HEMOSTAT",
  "drug_information": {
    "unit": 5.0,
    "type": "GR"
  },
  "code_information": [
    {
      "code": "82526100005",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 139.21,
      "maximum": 2785.64,
      "gross_charge": 556.85,
      "discounted_cash": 306.27,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 361.9525,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 377.5443,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 139.2125,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 473.3225,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 473.3225,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 2785.642125,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 183.704815,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 163.212735,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 334.11,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 445.48,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 194.8975,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 473.3225,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 417.6375,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 194.8975,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 222.74,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 325.812935,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 325.812935,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 371.08484,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 378.658,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 445.48,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 417.6375,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 155.918,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 194.8975,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 194.8975,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 386.4539,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 470.53825,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 356.384,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 306.2675,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 473.3225,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 473.3225,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 417.6375,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 281.20925,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 281.20925,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 311.836,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 445.48,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 306.2675,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 306.2675,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 222.74,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 361.9525,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 417.6375,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 222.74,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 445.48,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 361.9525,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 501.165,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 403.82762,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 306.2675,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 417.6375,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 417.6375,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 445.48,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 417.6375,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 361.9525,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 417.6375,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 194.8975,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 322.973,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 361.9525,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 361.9525,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 361.9525,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 445.48,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 445.48,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 361.9525,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 217.72835,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 182.6468,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 224.9674,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 187.1016,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 222.74,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 139.2125,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 439.967185,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 433.396355,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 439.13191,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 433.396355,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 439.13191,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 381.33088,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 386.398215,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 389.795,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 417.6375,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 361.9525,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 361.9525,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ABSORBASE EX OINT",
  "drug_information": {
    "unit": 454.0,
    "type": "GR"
  },
  "code_information": [
    {
      "code": "46287050716",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 12.86,
      "maximum": 46.29,
      "gross_charge": 51.43,
      "discounted_cash": 28.29,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.4295,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 34.86954,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.8575,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.7155,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.7155,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 41.509153,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 16.966757,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 15.074133,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 30.858,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 41.144,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.0005,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.7155,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5725,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 18.0005,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 20.572,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.721647,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.721647,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.272952,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.9724,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 41.144,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5725,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.4004,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 18.0005,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 18.0005,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 35.69242,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 43.45835,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 32.9152,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.2865,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 43.7155,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.7155,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5725,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 25.97215,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 25.97215,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 28.8008,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 41.144,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 28.2865,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 28.2865,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 20.572,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.4295,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5725,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 20.572,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.4295,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 41.144,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.287,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 28.2865,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 37.297036,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5725,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5725,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 41.144,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5725,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.4295,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5725,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.0005,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29.8294,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.4295,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.4295,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.4295,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 41.144,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 41.144,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.4295,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 20.10913,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.86904,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 20.77772,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17.28048,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 20.572,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.8575,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 40.634843,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 40.027969,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 40.557698,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 40.027969,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 40.557698,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 35.219264,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 35.687277,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.001,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5725,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.4295,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.4295,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "Absorpt drg <=16 sq in w/bdr",
  "code_information": [
    {
      "code": "A6254",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2.77,
      "maximum": 2.77,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.774204,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Absorpt drg <=16 sq in w/o b",
  "code_information": [
    {
      "code": "A6251",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 4.62,
      "maximum": 4.62,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4.618136,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Absorpt drg > 48 sq in w/o b",
  "code_information": [
    {
      "code": "A6253",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 14.7,
      "maximum": 14.7,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 14.70162,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Absorpt drg >16 <=48 w/o bdr",
  "code_information": [
    {
      "code": "A6252",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 7.56,
      "maximum": 7.56,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 7.55846,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Absorpt drg >16<=48 in w/bdr",
  "code_information": [
    {
      "code": "A6255",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 7.06,
      "maximum": 7.06,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 7.0601,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Acapatch, per sq cm",
  "code_information": [
    {
      "code": "Q4325",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 160.06,
      "maximum": 459.36,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 384.1356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 445.861716,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 161.5441,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 192.0678,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 459.362155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACD FORMULA A 0.73-2.45-2.2 GM/100ML VI SOLN",
  "drug_information": {
    "unit": 750.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "14537081775",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 10.0,
      "maximum": 200.1,
      "gross_charge": 40.0,
      "discounted_cash": 22.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.12,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 200.1,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 13.196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 11.724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 24.0,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 23.404,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 23.404,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.2,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11.2,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.76,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 33.8,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25.6,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.2,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.2,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 22.4,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.0,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29.008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.2,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.64,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.12,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.16,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.44,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACD FORMULA A 0.73-2.45-2.2 GM/100ML VI SOLN (ADULT CRRT)",
  "drug_information": {
    "unit": 750.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "14537081775_2",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 10.0,
      "maximum": 200.1,
      "gross_charge": 40.0,
      "discounted_cash": 22.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.12,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 200.1,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 13.196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 11.724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 24.0,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 23.404,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 23.404,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.2,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11.2,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.76,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 33.8,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25.6,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.2,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.2,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 22.4,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.0,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29.008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.2,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.64,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.12,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.16,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.44,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACD FORMULA A 0.73-2.45-2.2 GM/100ML VI SOLN (APHERESIS)",
  "drug_information": {
    "unit": 750.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "14537081775_3",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 10.0,
      "maximum": 200.1,
      "gross_charge": 40.0,
      "discounted_cash": 22.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.12,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 200.1,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 13.196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 11.724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 24.0,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 23.404,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 23.404,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.2,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11.2,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.76,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 33.8,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25.6,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.2,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.2,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 22.4,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.0,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29.008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.2,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.12,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.64,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.16,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.44,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACD FORMULA A 0.73-2.45-2.2 GM/100ML VI SOLN (PEDS CRRT NXSTAGE)",
  "drug_information": {
    "unit": 750.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "14537081775_4",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 10.0,
      "maximum": 200.1,
      "gross_charge": 40.0,
      "discounted_cash": 22.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.12,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 200.1,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 13.196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 11.724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 24.0,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 23.404,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 23.404,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.2,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11.2,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.76,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 33.8,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25.6,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.2,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.2,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 22.4,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.0,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29.008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.2,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.64,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.12,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.16,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.44,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACD FORMULA A 0.73-2.45-2.2 GM/100ML VI SOLN (PEDS CRRT PRISMAFLEX)",
  "drug_information": {
    "unit": 750.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "14537081775_5",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 10.0,
      "maximum": 200.1,
      "gross_charge": 40.0,
      "discounted_cash": 22.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.12,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 200.1,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 13.196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 11.724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 24.0,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 23.404,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 23.404,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.2,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11.2,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.76,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 33.8,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25.6,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.2,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.2,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 22.4,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.0,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29.008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.2,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.64,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.12,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.16,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.44,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "Acelagraft per sq cm",
  "code_information": [
    {
      "code": "Q4395",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 160.06,
      "maximum": 459.36,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 384.1356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 445.861716,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 161.5441,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 192.0678,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 459.362155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Acesso ac, per sq cm",
  "code_information": [
    {
      "code": "Q4312",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 160.06,
      "maximum": 459.36,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 384.1356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 445.861716,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 161.5441,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 192.0678,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 459.362155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Acesso dl, per sq cm",
  "code_information": [
    {
      "code": "Q4293",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 160.06,
      "maximum": 459.36,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 384.1356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 445.861716,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 161.5441,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 192.0678,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 459.362155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Acesso tl, per sq cm",
  "code_information": [
    {
      "code": "Q4300",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 160.06,
      "maximum": 459.36,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 384.1356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 445.861716,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 161.5441,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 192.0678,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 459.362155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Acesso trifaca per sq cm",
  "code_information": [
    {
      "code": "Q4386",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 160.06,
      "maximum": 459.36,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 384.1356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 445.861716,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 161.5441,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 192.0678,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 459.362155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Acesso, per sq cm",
  "code_information": [
    {
      "code": "Q4311",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 160.06,
      "maximum": 459.36,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 384.1356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 445.861716,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 161.5441,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 192.0678,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 459.362155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACETAMINOPHEN 10 MG/ML 0-50 ML SYRINGE",
  "drug_information": {
    "unit": 100.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00264410090_2",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 0.07,
      "maximum": 550.28,
      "gross_charge": 110.0,
      "discounted_cash": 60.5,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 74.58,
          "standard_charge_percentage": 67.8,
          "median_amount": 78.76,
          "10th_percentile": 65.4,
          "90th_percentile": 86.59,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 27.5,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 550.275,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 36.289,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 32.241,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 0.102,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "median_amount": 10.0,
          "10th_percentile": 10.0,
          "90th_percentile": 10.0,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 0.102,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "median_amount": 19.24,
          "10th_percentile": 0.38,
          "90th_percentile": 38.11,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "median_amount": 19.24,
          "10th_percentile": 0.38,
          "90th_percentile": 38.11,
          "count": "1 through 10",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 0.072,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 64.361,
          "standard_charge_percentage": 58.51,
          "median_amount": 64.36,
          "10th_percentile": 61.29,
          "90th_percentile": 64.36,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 64.361,
          "standard_charge_percentage": 58.51,
          "median_amount": 64.36,
          "10th_percentile": 61.29,
          "90th_percentile": 64.36,
          "count": "164",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 73.304,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.8,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.8,
          "standard_charge_percentage": 28.0,
          "median_amount": 30.8,
          "10th_percentile": 30.8,
          "90th_percentile": 30.8,
          "count": "12",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 76.34,
          "standard_charge_percentage": 69.4,
          "median_amount": 81.2,
          "10th_percentile": 78.71,
          "90th_percentile": 81.74,
          "count": "114",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 92.95,
          "standard_charge_percentage": 84.5,
          "median_amount": 85.59,
          "10th_percentile": 65.25,
          "90th_percentile": 88.62,
          "count": "17",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 70.4,
          "standard_charge_percentage": 64.0,
          "median_amount": 13.4,
          "10th_percentile": 13.4,
          "90th_percentile": 13.4,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 55.55,
          "standard_charge_percentage": 50.5,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 55.55,
          "standard_charge_percentage": 50.5,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 61.6,
          "standard_charge_percentage": 56.0,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 0.084,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.51,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "median_amount": 5.0,
          "10th_percentile": 5.0,
          "90th_percentile": 5.0,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 99.0,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 79.772,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 63.8,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.01,
          "standard_charge_percentage": 39.1,
          "median_amount": 36.41,
          "10th_percentile": 36.41,
          "90th_percentile": 37.84,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.08,
          "standard_charge_percentage": 32.8,
          "median_amount": 36.41,
          "10th_percentile": 36.41,
          "90th_percentile": 37.84,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.44,
          "standard_charge_percentage": 40.4,
          "median_amount": 37.29,
          "10th_percentile": 35.53,
          "90th_percentile": 37.29,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.96,
          "standard_charge_percentage": 33.6,
          "median_amount": 37.29,
          "10th_percentile": 35.53,
          "90th_percentile": 37.29,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 27.5,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.911,
          "standard_charge_percentage": 79.01,
          "median_amount": 51.7,
          "10th_percentile": 51.7,
          "90th_percentile": 51.7,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.613,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.746,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "median_amount": 5.18,
          "10th_percentile": 5.18,
          "90th_percentile": 62.63,
          "count": "1 through 10",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.613,
          "standard_charge_percentage": 77.83,
          "median_amount": 85.72,
          "10th_percentile": 75.43,
          "90th_percentile": 110.0,
          "count": "45",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.746,
          "standard_charge_percentage": 78.86,
          "median_amount": 85.72,
          "10th_percentile": 75.43,
          "90th_percentile": 110.0,
          "count": "45",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 75.328,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 76.329,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAMINOPHEN 10 MG/ML 0-50 ML SYRINGE (2 DAY MAX DURATION)",
  "drug_information": {
    "unit": 100.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00264410090_3",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 0.07,
      "maximum": 550.28,
      "gross_charge": 110.0,
      "discounted_cash": 60.5,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 74.58,
          "standard_charge_percentage": 67.8,
          "median_amount": 78.76,
          "10th_percentile": 65.4,
          "90th_percentile": 86.59,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 27.5,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 550.275,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 36.289,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 32.241,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 0.102,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 0.102,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "median_amount": 10.0,
          "10th_percentile": 10.0,
          "90th_percentile": 10.0,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "median_amount": 19.24,
          "10th_percentile": 0.38,
          "90th_percentile": 38.11,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "median_amount": 19.24,
          "10th_percentile": 0.38,
          "90th_percentile": 38.11,
          "count": "1 through 10",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 0.072,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 64.361,
          "standard_charge_percentage": 58.51,
          "median_amount": 64.36,
          "10th_percentile": 61.29,
          "90th_percentile": 64.36,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 64.361,
          "standard_charge_percentage": 58.51,
          "median_amount": 64.36,
          "10th_percentile": 61.29,
          "90th_percentile": 64.36,
          "count": "164",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 73.304,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.8,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.8,
          "standard_charge_percentage": 28.0,
          "median_amount": 30.8,
          "10th_percentile": 30.8,
          "90th_percentile": 30.8,
          "count": "12",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 76.34,
          "standard_charge_percentage": 69.4,
          "median_amount": 81.2,
          "10th_percentile": 78.71,
          "90th_percentile": 81.74,
          "count": "114",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 92.95,
          "standard_charge_percentage": 84.5,
          "median_amount": 85.59,
          "10th_percentile": 65.25,
          "90th_percentile": 88.62,
          "count": "17",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 70.4,
          "standard_charge_percentage": 64.0,
          "median_amount": 13.4,
          "10th_percentile": 13.4,
          "90th_percentile": 13.4,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 55.55,
          "standard_charge_percentage": 50.5,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 61.6,
          "standard_charge_percentage": 56.0,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 55.55,
          "standard_charge_percentage": 50.5,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 0.084,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.51,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "median_amount": 5.0,
          "10th_percentile": 5.0,
          "90th_percentile": 5.0,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 99.0,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 79.772,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 63.8,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.01,
          "standard_charge_percentage": 39.1,
          "median_amount": 36.41,
          "10th_percentile": 36.41,
          "90th_percentile": 37.84,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.08,
          "standard_charge_percentage": 32.8,
          "median_amount": 36.41,
          "10th_percentile": 36.41,
          "90th_percentile": 37.84,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.44,
          "standard_charge_percentage": 40.4,
          "median_amount": 37.29,
          "10th_percentile": 35.53,
          "90th_percentile": 37.29,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.96,
          "standard_charge_percentage": 33.6,
          "median_amount": 37.29,
          "10th_percentile": 35.53,
          "90th_percentile": 37.29,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 27.5,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.911,
          "standard_charge_percentage": 79.01,
          "median_amount": 51.7,
          "10th_percentile": 51.7,
          "90th_percentile": 51.7,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.613,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.746,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "median_amount": 5.18,
          "10th_percentile": 5.18,
          "90th_percentile": 62.63,
          "count": "1 through 10",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.613,
          "standard_charge_percentage": 77.83,
          "median_amount": 85.72,
          "10th_percentile": 75.43,
          "90th_percentile": 110.0,
          "count": "45",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.746,
          "standard_charge_percentage": 78.86,
          "median_amount": 85.72,
          "10th_percentile": 75.43,
          "90th_percentile": 110.0,
          "count": "45",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 75.328,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 76.329,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAMINOPHEN 10 MG/ML 50-100 ML INTRAVIA",
  "drug_information": {
    "unit": 100.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00264410090_4",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 0.07,
      "maximum": 550.28,
      "gross_charge": 110.0,
      "discounted_cash": 60.5,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 74.58,
          "standard_charge_percentage": 67.8,
          "median_amount": 78.76,
          "10th_percentile": 65.4,
          "90th_percentile": 86.59,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 27.5,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 550.275,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 36.289,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 32.241,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 0.102,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 0.102,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "median_amount": 10.0,
          "10th_percentile": 10.0,
          "90th_percentile": 10.0,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "median_amount": 19.24,
          "10th_percentile": 0.38,
          "90th_percentile": 38.11,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "median_amount": 19.24,
          "10th_percentile": 0.38,
          "90th_percentile": 38.11,
          "count": "1 through 10",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 0.072,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 64.361,
          "standard_charge_percentage": 58.51,
          "median_amount": 64.36,
          "10th_percentile": 61.29,
          "90th_percentile": 64.36,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 64.361,
          "standard_charge_percentage": 58.51,
          "median_amount": 64.36,
          "10th_percentile": 61.29,
          "90th_percentile": 64.36,
          "count": "164",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 73.304,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.8,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.8,
          "standard_charge_percentage": 28.0,
          "median_amount": 30.8,
          "10th_percentile": 30.8,
          "90th_percentile": 30.8,
          "count": "12",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 76.34,
          "standard_charge_percentage": 69.4,
          "median_amount": 81.2,
          "10th_percentile": 78.71,
          "90th_percentile": 81.74,
          "count": "114",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 92.95,
          "standard_charge_percentage": 84.5,
          "median_amount": 85.59,
          "10th_percentile": 65.25,
          "90th_percentile": 88.62,
          "count": "17",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 70.4,
          "standard_charge_percentage": 64.0,
          "median_amount": 13.4,
          "10th_percentile": 13.4,
          "90th_percentile": 13.4,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 55.55,
          "standard_charge_percentage": 50.5,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 55.55,
          "standard_charge_percentage": 50.5,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 61.6,
          "standard_charge_percentage": 56.0,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 0.084,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.51,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "median_amount": 5.0,
          "10th_percentile": 5.0,
          "90th_percentile": 5.0,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 99.0,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 79.772,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 63.8,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.01,
          "standard_charge_percentage": 39.1,
          "median_amount": 36.41,
          "10th_percentile": 36.41,
          "90th_percentile": 37.84,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.08,
          "standard_charge_percentage": 32.8,
          "median_amount": 36.41,
          "10th_percentile": 36.41,
          "90th_percentile": 37.84,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.44,
          "standard_charge_percentage": 40.4,
          "median_amount": 37.29,
          "10th_percentile": 35.53,
          "90th_percentile": 37.29,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.96,
          "standard_charge_percentage": 33.6,
          "median_amount": 37.29,
          "10th_percentile": 35.53,
          "90th_percentile": 37.29,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 27.5,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.911,
          "standard_charge_percentage": 79.01,
          "median_amount": 51.7,
          "10th_percentile": 51.7,
          "90th_percentile": 51.7,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.613,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.746,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "median_amount": 5.18,
          "10th_percentile": 5.18,
          "90th_percentile": 62.63,
          "count": "1 through 10",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.613,
          "standard_charge_percentage": 77.83,
          "median_amount": 85.72,
          "10th_percentile": 75.43,
          "90th_percentile": 110.0,
          "count": "45",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.746,
          "standard_charge_percentage": 78.86,
          "median_amount": 85.72,
          "10th_percentile": 75.43,
          "90th_percentile": 110.0,
          "count": "45",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 76.329,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 75.328,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAMINOPHEN 10 MG/ML 50-100 ML INTRAVIA (2 DAY MAX DURATION)",
  "drug_information": {
    "unit": 100.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00264410090_5",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 0.07,
      "maximum": 550.28,
      "gross_charge": 110.0,
      "discounted_cash": 60.5,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 74.58,
          "standard_charge_percentage": 67.8,
          "median_amount": 78.76,
          "10th_percentile": 65.4,
          "90th_percentile": 86.59,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 27.5,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 550.275,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 36.289,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 32.241,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 0.102,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "median_amount": 10.0,
          "10th_percentile": 10.0,
          "90th_percentile": 10.0,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 0.102,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "median_amount": 19.24,
          "10th_percentile": 0.38,
          "90th_percentile": 38.11,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "median_amount": 19.24,
          "10th_percentile": 0.38,
          "90th_percentile": 38.11,
          "count": "1 through 10",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 0.072,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 64.361,
          "standard_charge_percentage": 58.51,
          "median_amount": 64.36,
          "10th_percentile": 61.29,
          "90th_percentile": 64.36,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 64.361,
          "standard_charge_percentage": 58.51,
          "median_amount": 64.36,
          "10th_percentile": 61.29,
          "90th_percentile": 64.36,
          "count": "164",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 73.304,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.8,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.8,
          "standard_charge_percentage": 28.0,
          "median_amount": 30.8,
          "10th_percentile": 30.8,
          "90th_percentile": 30.8,
          "count": "12",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 76.34,
          "standard_charge_percentage": 69.4,
          "median_amount": 81.2,
          "10th_percentile": 78.71,
          "90th_percentile": 81.74,
          "count": "114",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 92.95,
          "standard_charge_percentage": 84.5,
          "median_amount": 85.59,
          "10th_percentile": 65.25,
          "90th_percentile": 88.62,
          "count": "17",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 70.4,
          "standard_charge_percentage": 64.0,
          "median_amount": 13.4,
          "10th_percentile": 13.4,
          "90th_percentile": 13.4,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 55.55,
          "standard_charge_percentage": 50.5,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 55.55,
          "standard_charge_percentage": 50.5,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 61.6,
          "standard_charge_percentage": 56.0,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 0.084,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.51,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "median_amount": 5.0,
          "10th_percentile": 5.0,
          "90th_percentile": 5.0,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 99.0,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 79.772,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 63.8,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.01,
          "standard_charge_percentage": 39.1,
          "median_amount": 36.41,
          "10th_percentile": 36.41,
          "90th_percentile": 37.84,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.08,
          "standard_charge_percentage": 32.8,
          "median_amount": 36.41,
          "10th_percentile": 36.41,
          "90th_percentile": 37.84,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.44,
          "standard_charge_percentage": 40.4,
          "median_amount": 37.29,
          "10th_percentile": 35.53,
          "90th_percentile": 37.29,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.96,
          "standard_charge_percentage": 33.6,
          "median_amount": 37.29,
          "10th_percentile": 35.53,
          "90th_percentile": 37.29,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 27.5,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.911,
          "standard_charge_percentage": 79.01,
          "median_amount": 51.7,
          "10th_percentile": 51.7,
          "90th_percentile": 51.7,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.613,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.746,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "median_amount": 5.18,
          "10th_percentile": 5.18,
          "90th_percentile": 62.63,
          "count": "1 through 10",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.613,
          "standard_charge_percentage": 77.83,
          "median_amount": 85.72,
          "10th_percentile": 75.43,
          "90th_percentile": 110.0,
          "count": "45",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.746,
          "standard_charge_percentage": 78.86,
          "median_amount": 85.72,
          "10th_percentile": 75.43,
          "90th_percentile": 110.0,
          "count": "45",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 76.329,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 75.328,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAMINOPHEN 10 MG/ML IV SOLN",
  "drug_information": {
    "unit": 100.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00264410090_6",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 0.07,
      "maximum": 550.28,
      "gross_charge": 110.0,
      "discounted_cash": 60.5,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 74.58,
          "standard_charge_percentage": 67.8,
          "median_amount": 78.76,
          "10th_percentile": 65.4,
          "90th_percentile": 86.59,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 27.5,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 550.275,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 36.289,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 32.241,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 0.102,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 0.102,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "median_amount": 10.0,
          "10th_percentile": 10.0,
          "90th_percentile": 10.0,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "median_amount": 19.24,
          "10th_percentile": 0.38,
          "90th_percentile": 38.11,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "median_amount": 19.24,
          "10th_percentile": 0.38,
          "90th_percentile": 38.11,
          "count": "1 through 10",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 0.072,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 64.361,
          "standard_charge_percentage": 58.51,
          "median_amount": 64.36,
          "10th_percentile": 61.29,
          "90th_percentile": 64.36,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 64.361,
          "standard_charge_percentage": 58.51,
          "median_amount": 64.36,
          "10th_percentile": 61.29,
          "90th_percentile": 64.36,
          "count": "164",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 73.304,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.8,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.8,
          "standard_charge_percentage": 28.0,
          "median_amount": 30.8,
          "10th_percentile": 30.8,
          "90th_percentile": 30.8,
          "count": "12",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 76.34,
          "standard_charge_percentage": 69.4,
          "median_amount": 81.2,
          "10th_percentile": 78.71,
          "90th_percentile": 81.74,
          "count": "114",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 92.95,
          "standard_charge_percentage": 84.5,
          "median_amount": 85.59,
          "10th_percentile": 65.25,
          "90th_percentile": 88.62,
          "count": "17",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 70.4,
          "standard_charge_percentage": 64.0,
          "median_amount": 13.4,
          "10th_percentile": 13.4,
          "90th_percentile": 13.4,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 55.55,
          "standard_charge_percentage": 50.5,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 55.55,
          "standard_charge_percentage": 50.5,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 61.6,
          "standard_charge_percentage": 56.0,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 0.084,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.51,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "median_amount": 5.0,
          "10th_percentile": 5.0,
          "90th_percentile": 5.0,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 99.0,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 79.772,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 63.8,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.01,
          "standard_charge_percentage": 39.1,
          "median_amount": 36.41,
          "10th_percentile": 36.41,
          "90th_percentile": 37.84,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.08,
          "standard_charge_percentage": 32.8,
          "median_amount": 36.41,
          "10th_percentile": 36.41,
          "90th_percentile": 37.84,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.44,
          "standard_charge_percentage": 40.4,
          "median_amount": 37.29,
          "10th_percentile": 35.53,
          "90th_percentile": 37.29,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.96,
          "standard_charge_percentage": 33.6,
          "median_amount": 37.29,
          "10th_percentile": 35.53,
          "90th_percentile": 37.29,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 27.5,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.911,
          "standard_charge_percentage": 79.01,
          "median_amount": 51.7,
          "10th_percentile": 51.7,
          "90th_percentile": 51.7,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.613,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.746,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "median_amount": 5.18,
          "10th_percentile": 5.18,
          "90th_percentile": 62.63,
          "count": "1 through 10",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.613,
          "standard_charge_percentage": 77.83,
          "median_amount": 85.72,
          "10th_percentile": 75.43,
          "90th_percentile": 110.0,
          "count": "45",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.746,
          "standard_charge_percentage": 78.86,
          "median_amount": 85.72,
          "10th_percentile": 75.43,
          "90th_percentile": 110.0,
          "count": "45",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 75.328,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 76.329,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAMINOPHEN 10 MG/ML IV SOLN (2 DAY MAX DURATION)",
  "drug_information": {
    "unit": 100.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00264410090_7",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 0.07,
      "maximum": 550.28,
      "gross_charge": 110.0,
      "discounted_cash": 60.5,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 74.58,
          "standard_charge_percentage": 67.8,
          "median_amount": 78.76,
          "10th_percentile": 65.4,
          "90th_percentile": 86.59,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 27.5,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 550.275,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 36.289,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 32.241,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 0.102,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 0.102,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "median_amount": 10.0,
          "10th_percentile": 10.0,
          "90th_percentile": 10.0,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "median_amount": 19.24,
          "10th_percentile": 0.38,
          "90th_percentile": 38.11,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "median_amount": 19.24,
          "10th_percentile": 0.38,
          "90th_percentile": 38.11,
          "count": "1 through 10",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 0.072,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 64.361,
          "standard_charge_percentage": 58.51,
          "median_amount": 64.36,
          "10th_percentile": 61.29,
          "90th_percentile": 64.36,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 64.361,
          "standard_charge_percentage": 58.51,
          "median_amount": 64.36,
          "10th_percentile": 61.29,
          "90th_percentile": 64.36,
          "count": "164",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 73.304,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.8,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.8,
          "standard_charge_percentage": 28.0,
          "median_amount": 30.8,
          "10th_percentile": 30.8,
          "90th_percentile": 30.8,
          "count": "12",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 76.34,
          "standard_charge_percentage": 69.4,
          "median_amount": 81.2,
          "10th_percentile": 78.71,
          "90th_percentile": 81.74,
          "count": "114",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 92.95,
          "standard_charge_percentage": 84.5,
          "median_amount": 85.59,
          "10th_percentile": 65.25,
          "90th_percentile": 88.62,
          "count": "17",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 70.4,
          "standard_charge_percentage": 64.0,
          "median_amount": 13.4,
          "10th_percentile": 13.4,
          "90th_percentile": 13.4,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 55.55,
          "standard_charge_percentage": 50.5,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 55.55,
          "standard_charge_percentage": 50.5,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 61.6,
          "standard_charge_percentage": 56.0,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 0.084,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.51,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "median_amount": 5.0,
          "10th_percentile": 5.0,
          "90th_percentile": 5.0,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 99.0,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 79.772,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 63.8,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.01,
          "standard_charge_percentage": 39.1,
          "median_amount": 36.41,
          "10th_percentile": 36.41,
          "90th_percentile": 37.84,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.08,
          "standard_charge_percentage": 32.8,
          "median_amount": 36.41,
          "10th_percentile": 36.41,
          "90th_percentile": 37.84,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.44,
          "standard_charge_percentage": 40.4,
          "median_amount": 37.29,
          "10th_percentile": 35.53,
          "90th_percentile": 37.29,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.96,
          "standard_charge_percentage": 33.6,
          "median_amount": 37.29,
          "10th_percentile": 35.53,
          "90th_percentile": 37.29,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 27.5,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.911,
          "standard_charge_percentage": 79.01,
          "median_amount": 51.7,
          "10th_percentile": 51.7,
          "90th_percentile": 51.7,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.613,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.746,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "median_amount": 5.18,
          "10th_percentile": 5.18,
          "90th_percentile": 62.63,
          "count": "1 through 10",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.613,
          "standard_charge_percentage": 77.83,
          "median_amount": 85.72,
          "10th_percentile": 75.43,
          "90th_percentile": 110.0,
          "count": "45",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.746,
          "standard_charge_percentage": 78.86,
          "median_amount": 85.72,
          "10th_percentile": 75.43,
          "90th_percentile": 110.0,
          "count": "45",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 75.328,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 76.329,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAMINOPHEN 10 MG/ML SYRINGE (NICU)",
  "drug_information": {
    "unit": 100.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00264410090",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 0.07,
      "maximum": 200.1,
      "gross_charge": 40.0,
      "discounted_cash": 22.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.12,
          "standard_charge_percentage": 67.8,
          "median_amount": 78.76,
          "10th_percentile": 65.4,
          "90th_percentile": 86.59,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 200.1,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 13.196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 11.724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "median_amount": 10.0,
          "10th_percentile": 10.0,
          "90th_percentile": 10.0,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 0.102,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 0.102,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "median_amount": 19.24,
          "10th_percentile": 0.38,
          "90th_percentile": 38.11,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "median_amount": 19.24,
          "10th_percentile": 0.38,
          "90th_percentile": 38.11,
          "count": "1 through 10",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 0.072,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 23.404,
          "standard_charge_percentage": 58.51,
          "median_amount": 64.36,
          "10th_percentile": 61.29,
          "90th_percentile": 64.36,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 23.404,
          "standard_charge_percentage": 58.51,
          "median_amount": 64.36,
          "10th_percentile": 61.29,
          "90th_percentile": 64.36,
          "count": "164",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.2,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11.2,
          "standard_charge_percentage": 28.0,
          "median_amount": 30.8,
          "10th_percentile": 30.8,
          "90th_percentile": 30.8,
          "count": "12",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.76,
          "standard_charge_percentage": 69.4,
          "median_amount": 81.2,
          "10th_percentile": 78.71,
          "90th_percentile": 81.74,
          "count": "114",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 33.8,
          "standard_charge_percentage": 84.5,
          "median_amount": 85.59,
          "10th_percentile": 65.25,
          "90th_percentile": 88.62,
          "count": "17",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25.6,
          "standard_charge_percentage": 64.0,
          "median_amount": 13.4,
          "10th_percentile": 13.4,
          "90th_percentile": 13.4,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.2,
          "standard_charge_percentage": 50.5,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.2,
          "standard_charge_percentage": 50.5,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 22.4,
          "standard_charge_percentage": 56.0,
          "median_amount": 64.68,
          "10th_percentile": 62.48,
          "90th_percentile": 65.89,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 0.084,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.51,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "median_amount": 5.0,
          "10th_percentile": 5.0,
          "90th_percentile": 5.0,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.0,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29.008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.2,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.12,
          "standard_charge_percentage": 32.8,
          "median_amount": 36.41,
          "10th_percentile": 36.41,
          "90th_percentile": 37.84,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.64,
          "standard_charge_percentage": 39.1,
          "median_amount": 36.41,
          "10th_percentile": 36.41,
          "90th_percentile": 37.84,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.16,
          "standard_charge_percentage": 40.4,
          "median_amount": 37.29,
          "10th_percentile": 35.53,
          "90th_percentile": 37.29,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.44,
          "standard_charge_percentage": 33.6,
          "median_amount": 37.29,
          "10th_percentile": 35.53,
          "90th_percentile": 37.29,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.604,
          "standard_charge_percentage": 79.01,
          "median_amount": 51.7,
          "10th_percentile": 51.7,
          "90th_percentile": 51.7,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "median_amount": 5.18,
          "10th_percentile": 5.18,
          "90th_percentile": 62.63,
          "count": "1 through 10",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.132,
          "standard_charge_percentage": 77.83,
          "median_amount": 85.72,
          "10th_percentile": 75.43,
          "90th_percentile": 110.0,
          "count": "45",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.544,
          "standard_charge_percentage": 78.86,
          "median_amount": 85.72,
          "10th_percentile": 75.43,
          "90th_percentile": 110.0,
          "count": "45",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAMINOPHEN 120 MG RE SUPP",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "51672211502",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.0,
      "maximum": 3.6,
      "gross_charge": 4.0,
      "discounted_cash": 2.2,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.712,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.2284,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.3196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.1724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.4,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.72,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.12,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.776,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.38,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.56,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.24,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.9008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.32,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.564,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.312,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.616,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.344,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAMINOPHEN 32 MG/ML PO LIQUID",
  "drug_information": {
    "unit": 2.5,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "68094013058",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.0,
      "maximum": 3.6,
      "gross_charge": 4.0,
      "discounted_cash": 2.2,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.712,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.2284,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.3196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.1724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.4,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.72,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.12,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.776,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.38,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.56,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.24,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.9008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.32,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.564,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.312,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.616,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.344,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAMINOPHEN 325 MG PO TABS",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "50580045811",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.0,
      "maximum": 3.6,
      "gross_charge": 4.0,
      "discounted_cash": 2.2,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.712,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.2284,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.3196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.1724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.4,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.72,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.12,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.776,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.38,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.56,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.24,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.9008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.32,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.564,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.312,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.616,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.344,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAMINOPHEN 325 MG RE SUPP",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "51672211602",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.0,
      "maximum": 3.6,
      "gross_charge": 4.0,
      "discounted_cash": 2.2,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.712,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.2284,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.3196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.1724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.4,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.72,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.12,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.776,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.38,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.56,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.24,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.9008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.32,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.564,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.312,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.616,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.344,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAMINOPHEN 500 MG PO TABS",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00904673061",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.0,
      "maximum": 3.6,
      "gross_charge": 4.0,
      "discounted_cash": 2.2,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.712,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.2284,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.3196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.1724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.4,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.72,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.12,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.776,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.38,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.56,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.24,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.9008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.32,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.564,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.312,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.616,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.344,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAMINOPHEN 650 MG RE SUPP",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "45802073032",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.0,
      "maximum": 3.6,
      "gross_charge": 4.0,
      "discounted_cash": 2.2,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.712,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.2284,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.3196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.1724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.4,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.72,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.12,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.776,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.38,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.56,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.24,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.9008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.32,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.564,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.312,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.616,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.344,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAMINOPHEN 80 MG PO CHEW",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00904579146",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.0,
      "maximum": 3.6,
      "gross_charge": 4.0,
      "discounted_cash": 2.2,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.712,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.2284,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.3196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.1724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.4,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.72,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.12,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.776,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.38,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.56,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.24,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.9008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.32,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.564,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.312,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.616,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.344,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAMINOPHEN-CODEINE 120-12 MG/5ML PO SOLN",
  "drug_information": {
    "unit": 15.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "1785607901",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 3.3,
      "maximum": 11.89,
      "gross_charge": 13.21,
      "discounted_cash": 7.27,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.5865,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 8.95638,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.3025,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11.2285,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11.2285,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 10.661791,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4.357979,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.871851,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 7.926,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4.6235,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 10.568,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11.2285,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.9075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.6235,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.284,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.945809,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.945809,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.803144,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.9828,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 10.568,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.9075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.6988,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.6235,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.6235,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 9.16774,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 11.16245,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.4544,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.2655,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11.2285,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.2285,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.9075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6.67105,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6.67105,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 7.3976,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.568,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7.2655,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7.2655,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.284,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.5865,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.9075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.284,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.568,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.5865,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11.889,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7.2655,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.579892,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.9075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.9075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.568,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.9075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.5865,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.9075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4.6235,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.6618,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.5865,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.5865,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.5865,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.568,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.568,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.5865,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.16511,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.33288,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.33684,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.43856,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.284,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.3025,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.437221,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.281343,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.417406,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.281343,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.417406,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.046208,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.166419,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.247,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.9075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.5865,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.5865,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAMINOPHEN-CODEINE 300-30 MG PO TABS",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00406048462",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2.0,
      "maximum": 7.2,
      "gross_charge": 8.0,
      "discounted_cash": 4.4,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.2,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5.424,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.8,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.8,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6.4568,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.6392,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.3448,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 6.4,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 4.8,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.8,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0232,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0232,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.3312,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.44,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 6.4,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.24,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5.552,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6.76,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.12,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.4,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.8,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6.8,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4.04,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4.04,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 4.48,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.4,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4.4,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4.4,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.2,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.2,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.4,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.2,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4.4,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.8016,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.4,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.2,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.64,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.2,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.2,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.2,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.4,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.4,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.2,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.128,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.624,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.232,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.688,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.3208,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.2264,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.3088,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.2264,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.3088,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.4784,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.5512,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.2,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.2,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAMINOPHEN-CODEINE 300-60 MG PO TABS",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "1310706001",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2.0,
      "maximum": 7.2,
      "gross_charge": 8.0,
      "discounted_cash": 4.4,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.2,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5.424,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.8,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.8,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6.4568,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.6392,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.3448,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 4.8,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 6.4,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.8,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0232,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0232,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.3312,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.44,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 6.4,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.24,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5.552,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6.76,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.12,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.4,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6.8,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.8,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4.04,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 4.48,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4.04,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.4,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4.4,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4.4,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.2,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.2,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.4,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.2,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.8016,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4.4,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.4,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.2,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.64,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.2,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.2,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.2,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.4,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.4,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.2,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.128,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.624,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.232,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.688,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.3208,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.2264,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.3088,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.2264,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.3088,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.4784,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.5512,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.6,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.2,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.2,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAZOLAMIDE 100 MG/ML SYRINGE(PEDS)",
  "drug_information": {
    "unit": 5.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "09992019007",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 32.33,
      "maximum": 646.97,
      "gross_charge": 129.33,
      "discounted_cash": 71.13,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 84.0645,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 87.68574,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 32.3325,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 109.9305,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 109.9305,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 646.973325,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 42.665967,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 37.906623,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 77.598,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 45.2655,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 103.464,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 109.9305,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 96.9975,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 45.2655,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 51.732,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 75.670983,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 75.670983,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.185512,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 87.9444,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 103.464,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 96.9975,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.2124,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 45.2655,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 45.2655,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 89.75502,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 109.28385,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 82.7712,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.1315,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 109.9305,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 109.9305,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 96.9975,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 65.31165,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 65.31165,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 72.4248,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 103.464,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 71.1315,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 71.1315,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 51.732,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 84.0645,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 96.9975,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 51.732,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 84.0645,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 103.464,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 116.397,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.790116,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 71.1315,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 96.9975,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 96.9975,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 103.464,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 96.9975,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 84.0645,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 96.9975,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 45.2655,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 75.0114,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 84.0645,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 84.0645,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 84.0645,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 103.464,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 103.464,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 84.0645,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.56803,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 42.42024,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 52.24932,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.45488,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 51.732,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 32.3325,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 102.183633,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 101.989638,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 100.657539,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 100.657539,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 101.989638,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.565184,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 89.742087,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 90.531,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 96.9975,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 84.0645,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 84.0645,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAZOLAMIDE 250 MG PO TABS",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "50268005415",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.07,
      "maximum": 3.83,
      "gross_charge": 4.26,
      "discounted_cash": 2.34,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.769,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.88828,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.065,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.621,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.621,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.438246,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.405374,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.248606,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.491,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.556,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3.408,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.621,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.195,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.491,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.704,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.207354,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.207354,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.838864,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8968,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3.408,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.195,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.1928,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.491,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.491,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.95644,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.5997,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.7264,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.343,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.621,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.621,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.195,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.1513,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.1513,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.3856,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.408,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.343,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.343,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.704,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.769,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.195,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.704,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.769,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.408,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.834,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.089352,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.343,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.195,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.195,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.408,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.195,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.769,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.195,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.491,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.4708,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.769,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.769,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.769,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.408,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.408,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.769,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.66566,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.39728,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.72104,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.43136,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.704,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.065,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.365826,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.315558,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.359436,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.315558,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.359436,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.917248,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.956014,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.982,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.195,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.769,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.769,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAZOLAMIDE 25MG/ML ORAL SUSPENSION",
  "drug_information": {
    "unit": 10.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "P5167240231",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.02,
      "maximum": 3.65,
      "gross_charge": 4.06,
      "discounted_cash": 2.23,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.639,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.75268,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.015,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.451,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.451,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.276826,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.339394,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.189986,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3.248,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.436,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.421,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.451,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.045,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.421,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.624,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.056774,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.056774,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.705584,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7608,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3.248,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.045,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.1368,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.421,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.421,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.81764,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.4307,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.5984,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.233,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.451,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.451,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.045,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.0503,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.2736,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.0503,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.248,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.233,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.233,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.624,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.639,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.045,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.624,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.639,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.248,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.654,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.944312,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.233,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.045,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.045,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.248,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.045,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.639,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.045,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.421,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.3548,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.639,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.639,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.639,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.248,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.248,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.639,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.58746,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.33168,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.64024,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.36416,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.624,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.015,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.207806,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.159898,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.201716,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.159898,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.201716,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.817234,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.780288,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.842,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.045,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.639,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.639,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAZOLAMIDE ER 500 MG PO CP12",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "60687057821",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.9,
      "maximum": 6.85,
      "gross_charge": 7.61,
      "discounted_cash": 4.19,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.9465,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5.15958,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.9025,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.4685,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.4685,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6.142031,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.510539,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.230491,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.6635,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 6.088,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 4.566,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.4685,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.7075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6635,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.044,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.729569,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.729569,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.071304,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.1748,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 6.088,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.7075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.1308,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6635,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6635,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5.28134,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6.43045,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4.8704,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.1855,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.4685,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6.4685,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.7075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.84305,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.84305,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 4.2616,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.088,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4.1855,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4.1855,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.044,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.9465,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.7075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.044,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4.9465,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.088,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.849,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.518772,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4.1855,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.7075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.7075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.088,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.7075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.9465,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.7075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.6635,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.4138,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.9465,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.9465,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.9465,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.088,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.088,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.9465,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.97551,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.49608,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.07444,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.55696,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.044,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.9025,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.012661,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.922863,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.001246,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.922863,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.001246,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.211328,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.280579,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.327,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.7075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.9465,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.9465,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETAZOLAMIDE SODIUM 500 MG IJ SOLR",
  "drug_information": {
    "unit": 5.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "39822019001",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 16.56,
      "maximum": 331.42,
      "gross_charge": 66.25,
      "discounted_cash": 36.44,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.0625,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 44.9175,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.5625,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 56.3125,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 56.3125,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 331.415625,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 21.855875,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 19.417875,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23.1875,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 36.7115,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 36.7115,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 56.3125,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 49.6875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.1875,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.5,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 38.762875,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 38.762875,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.149,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 45.05,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 53.0,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 49.6875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 18.55,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.1875,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.1875,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 45.9775,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 55.98125,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 42.4,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.4375,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 56.3125,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 56.3125,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 49.6875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 33.45625,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 33.45625,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 37.1,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 53.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 36.4375,
          "standard_charge_percentage": 55.0,
          "median_amount": 28.5,
          "10th_percentile": 28.5,
          "90th_percentile": 28.5,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 36.4375,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.78,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.0625,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 49.6875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.5,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 43.0625,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 53.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 59.625,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.0445,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 36.4375,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 49.6875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 49.6875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 53.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 49.6875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.0625,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 49.6875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23.1875,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.425,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.0625,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.0625,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.0625,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 53.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 53.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.0625,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.90375,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 21.73,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.765,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 22.26,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.5,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.5625,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 52.344125,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 51.562375,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 52.24475,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 51.562375,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 52.24475,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 45.368,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 45.970875,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.375,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 49.6875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.0625,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.0625,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETIC ACID 0.25 % IR SOLN",
  "drug_information": {
    "unit": 1000.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00338065604",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 10.0,
      "maximum": 200.1,
      "gross_charge": 40.0,
      "discounted_cash": 22.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.12,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 200.1,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 13.196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 11.724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 24.0,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 23.404,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 23.404,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.2,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11.2,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.76,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 33.8,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25.6,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.2,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.2,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 22.4,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.0,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29.008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.2,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.64,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.12,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.16,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.44,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETIC ACID 2 % OT SOLN",
  "drug_information": {
    "unit": 15.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "52817081615",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 10.26,
      "maximum": 36.93,
      "gross_charge": 41.03,
      "discounted_cash": 22.57,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.6695,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.81834,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.2575,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.8755,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.8755,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 33.115313,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 13.535797,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 12.025893,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 24.618,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.3605,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 32.824,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.8755,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.7725,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.3605,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.412,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.891487,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.891487,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.342392,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.9004,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 32.824,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.7725,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11.4884,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.3605,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.3605,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 28.47482,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 34.67035,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 26.2592,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 22.5665,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.8755,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34.8755,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.7725,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.72015,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 22.9768,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.72015,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.824,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.5665,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.5665,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.412,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.6695,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.7725,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.412,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 26.6695,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.824,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.927,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29.754956,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.5665,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.7725,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.7725,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.824,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.7725,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.6695,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.7725,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.3605,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.7974,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.6695,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.6695,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.6695,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.824,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.824,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.6695,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.04273,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.45784,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.57612,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.78608,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.412,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.2575,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.417803,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.933649,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.356258,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.933649,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.356258,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.097344,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.470717,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.721,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.7725,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.6695,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.6695,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETIC ACID 3 % SOLN",
  "drug_information": {
    "unit": 30.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "P8252005130",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.0,
      "maximum": 20.01,
      "gross_charge": 4.0,
      "discounted_cash": 2.2,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.712,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.01,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.3196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.1724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.4,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 2.3404,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 2.3404,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.72,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.12,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.776,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.38,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.56,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.24,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.9008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.32,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.564,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.312,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.616,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.344,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETIC ACID 5% SOLN",
  "drug_information": {
    "unit": 60.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "P4444075330",
      "type": "NDC"
    },
    {
      "code": "P4444075360",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.0,
      "maximum": 20.01,
      "gross_charge": 4.0,
      "discounted_cash": 2.2,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.712,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.01,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.3196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.1724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.4,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 2.3404,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 2.3404,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.72,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.12,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.776,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.38,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.56,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.24,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.9008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.32,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.564,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.312,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.616,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.344,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETYLCHOLINE CHLORIDE 20 MG IO SOLR",
  "drug_information": {
    "unit": 0.5,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "24208053920",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 18.21,
      "maximum": 364.28,
      "gross_charge": 72.82,
      "discounted_cash": 40.05,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 47.333,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 49.37196,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.205,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 61.897,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 61.897,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 364.28205,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 24.023318,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 21.343542,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25.487,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 58.256,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 43.692,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 61.897,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.615,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.487,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29.128,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 42.606982,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 42.606982,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.527248,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 49.5176,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 58.256,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.615,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 20.3896,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.487,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.487,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 50.53708,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 61.5329,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 46.6048,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 40.051,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 61.897,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 61.897,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.615,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 36.7741,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 36.7741,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 40.7792,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.256,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 40.051,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 40.051,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29.128,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 47.333,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.615,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29.128,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 47.333,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.256,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 65.538,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 52.809064,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 40.051,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.615,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.615,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.256,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.615,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 47.333,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.615,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25.487,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 42.2356,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 47.333,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 47.333,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 47.333,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.256,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.256,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 47.333,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.47262,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.88496,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29.41928,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 24.46752,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29.128,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.205,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 57.535082,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 56.675806,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 57.425852,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 56.675806,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 57.425852,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 49.867136,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.529798,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.974,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.615,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 47.333,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 47.333,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETYLCHOLINE INTRACORONARY SYRINGE",
  "drug_information": {
    "unit": 12.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "09991000125",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 65.46,
      "maximum": 1309.9,
      "gross_charge": 261.85,
      "discounted_cash": 144.02,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 170.2025,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 177.5343,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 65.4625,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 222.5725,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 222.5725,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 1309.904625,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 86.384315,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 76.748235,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 209.48,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 91.6475,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 157.11,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 222.5725,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 196.3875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 91.6475,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 104.74,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 153.208435,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 153.208435,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 174.49684,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 178.058,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 209.48,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 196.3875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 73.318,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 91.6475,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 91.6475,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 181.7239,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 221.26325,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 167.584,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 144.0175,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 222.5725,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 222.5725,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 196.3875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 132.23425,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 132.23425,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 146.636,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 209.48,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 144.0175,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 144.0175,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 104.74,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 170.2025,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 196.3875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 104.74,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 209.48,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 170.2025,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 235.665,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 189.89362,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 144.0175,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 196.3875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 196.3875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 209.48,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 196.3875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 170.2025,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 196.3875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 91.6475,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 151.873,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 170.2025,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 170.2025,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 170.2025,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 209.48,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 209.48,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 170.2025,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.8868,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 102.38335,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 105.7874,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 87.9816,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 104.74,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 65.4625,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 206.887685,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 203.797855,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 206.49491,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 203.797855,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 206.49491,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 179.31488,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.697715,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.295,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 196.3875,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 170.2025,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 170.2025,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETYLCHOLINESTERASE ASSAY",
  "code_information": [
    {
      "code": "82013",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 9.93,
      "maximum": 35.27,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.29,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.416148,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 18.178139,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.29,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 29.496,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.748,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 33.9204,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.29,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.748,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 17.206,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.29,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.93,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.29,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 35.2723,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13.519,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.29,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.5915,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.29,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13.519,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.29,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.29,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.29,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACETYLCHOLN RCPTR BLCKG ANTB",
  "code_information": [
    {
      "code": "86042",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 18.4,
      "maximum": 52.81,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 30.56608,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.21544,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.16,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 50.784,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 52.808,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 20.24,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 24.84,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 20.24,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.4,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACETYLCHOLN RCPTR BNDNG ANTB",
  "code_information": [
    {
      "code": "86041",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 18.4,
      "maximum": 52.81,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 30.56608,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.21544,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.16,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 50.784,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 52.808,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 20.24,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 24.84,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 20.24,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.4,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACETYLCHOLN RCPTR MODLG ANTB",
  "code_information": [
    {
      "code": "86043",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 12.05,
      "maximum": 34.58,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.05,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.01746,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 17.823155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.05,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 28.92,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.46,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 33.258,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.05,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.46,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.05,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.05,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34.5835,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13.255,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.05,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.2675,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.05,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13.255,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.05,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.05,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.05,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACETYLCYSTEINE 20 % IN SOLN",
  "drug_information": {
    "unit": 3.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00517760425_2",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2.34,
      "maximum": 8.41,
      "gross_charge": 9.34,
      "discounted_cash": 5.14,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.071,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6.33252,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.335,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.939,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.939,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 7.538314,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.081266,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.737554,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 5.604,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 7.472,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.269,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.939,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.005,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.269,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.736,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.032086,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.032086,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.224176,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.3512,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 7.472,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.005,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6152,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.269,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.269,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6.48196,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 7.8923,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.9776,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.137,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.939,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7.939,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.005,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4.7167,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4.7167,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 5.2304,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.472,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.137,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.137,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.736,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.071,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.005,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.736,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.472,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6.071,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.406,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.773368,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.137,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.005,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.005,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.472,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.005,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.071,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.005,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.269,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.4172,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.071,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.071,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.071,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.472,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.472,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.071,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.65194,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.06352,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.77336,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.13824,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.736,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.335,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.379534,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.269322,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.365524,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.269322,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.365524,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.396032,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.481026,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.538,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.005,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.071,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6.071,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETYLCYSTEINE 20 % IN SOLN (INHALATION)",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00517760425",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.0,
      "maximum": 3.6,
      "gross_charge": 4.0,
      "discounted_cash": 2.2,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.712,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.2284,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.3196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.1724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.4,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.72,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.12,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.776,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.38,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.56,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.24,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.9008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.32,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.564,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.312,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.344,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.616,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETYLCYSTEINE 200 MG/ML IV SOLN",
  "drug_information": {
    "unit": 30.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "72611086004",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 0.43,
      "maximum": 419.11,
      "gross_charge": 83.78,
      "discounted_cash": 46.08,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.457,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 56.80284,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 20.945,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.213,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.213,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 419.10945,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.639022,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 24.555918,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 29.323,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 0.425,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 0.425,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.213,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 62.835,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29.323,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.512,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 49.019678,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 49.019678,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 55.830992,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 56.9704,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 67.024,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 62.835,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.4584,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29.323,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29.323,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 58.14332,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 70.7941,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.6192,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.079,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.213,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 71.213,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 62.835,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 42.3089,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 42.3089,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 46.9168,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 67.024,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 46.079,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 46.079,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.11,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.457,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 62.835,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.512,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.457,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 67.024,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 75.402,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 60.757256,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 46.079,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 62.835,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 62.835,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 67.024,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 62.835,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.457,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 62.835,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 29.323,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.5924,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.457,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.457,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.457,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 67.024,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 67.024,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.457,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.75798,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.47984,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.84712,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.15008,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.512,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 20.945,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 66.194578,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 65.205974,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 66.068908,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 65.205974,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 66.068908,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 57.372544,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.134942,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 58.646,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 62.835,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.457,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.457,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACETYLCYSTEINE OPHTHALMIC SOLN 20%",
  "drug_information": {
    "unit": 12.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "08252000247",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 27.5,
      "maximum": 550.28,
      "gross_charge": 110.0,
      "discounted_cash": 60.5,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 74.58,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 27.5,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 550.275,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 36.289,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 32.241,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 66.0,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 64.361,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 64.361,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 73.304,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.8,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.8,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 76.34,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 92.95,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 70.4,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 55.55,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 55.55,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 61.6,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 99.0,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 79.772,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 63.8,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 88.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 43.01,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.08,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.44,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.96,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 27.5,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.911,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.613,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.746,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.613,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.746,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 75.328,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 76.329,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 82.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACHR ANTB ID IMFLUOR LIVECLL",
  "code_information": [
    {
      "code": "0545U",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 37.73,
      "maximum": 108.29,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 90.552,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 104.1348,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 45.276,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 108.2851,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.73,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACID PERFUSION OF ESOPHAGUS",
  "code_information": [
    {
      "code": "91030",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 40.46,
      "maximum": 1377.44,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 479.943,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 824.32,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 734.59,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 674.1804,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1151.8632,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 803.61012,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1336.95366,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 484.4035,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 575.9316,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 937.54514,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 674.1804,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 40.46,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 674.1804,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1377.43641,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 741.59844,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 479.943,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 910.14354,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 479.943,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 741.59844,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 479.943,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 479.943,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 674.1804,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACITRETIN 10 MG PO CAPS",
  "drug_information": {
    "unit": 3.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "42794008008",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 42.39,
      "maximum": 152.6,
      "gross_charge": 169.56,
      "discounted_cash": 93.26,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 110.214,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 114.96168,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 42.39,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 144.126,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 144.126,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 136.851876,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 55.937844,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 49.698036,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 135.648,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 101.736,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 59.346,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 144.126,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 127.17,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 59.346,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 67.824,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 127.661724,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 127.661724,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 112.994784,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 115.3008,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 135.648,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 127.17,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 47.4768,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 59.346,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 59.346,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 117.67464,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 143.2782,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 108.5184,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 93.258,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 144.126,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 144.126,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 127.17,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 85.6278,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 85.6278,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 94.9536,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 135.648,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 93.258,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 93.258,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 67.824,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 110.214,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 127.17,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 67.824,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 110.214,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 135.648,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.604,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 122.964912,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 93.258,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 127.17,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 127.17,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 135.648,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 127.17,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 110.214,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 127.17,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 59.346,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 98.3448,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 110.214,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 110.214,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 110.214,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 135.648,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 135.648,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 110.214,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 66.29796,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 55.61568,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 68.50224,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 56.97216,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 67.824,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 42.39,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 133.969356,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 131.968548,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 133.715016,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 131.968548,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 133.715016,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 116.114688,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 117.657684,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 118.692,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 127.17,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 110.214,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 110.214,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACITRETIN 25 MG PO CAPS",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "42794008308",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 17.42,
      "maximum": 62.7,
      "gross_charge": 69.67,
      "discounted_cash": 38.32,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 45.2855,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 47.23626,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 17.4175,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 59.2195,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 59.2195,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 56.230657,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 22.984133,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.420277,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 55.736,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 24.3845,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 41.802,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 59.2195,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 52.2525,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 24.3845,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.868,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 52.454543,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 52.454543,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46.428088,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 47.3756,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 55.736,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 52.2525,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19.5076,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 24.3845,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 24.3845,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 48.35098,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 58.87115,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.5888,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.3185,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 59.2195,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 59.2195,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 52.2525,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 35.18335,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 35.18335,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 39.0152,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 55.736,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38.3185,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38.3185,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.868,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 45.2855,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 52.2525,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.868,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 45.2855,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 55.736,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 62.703,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 50.524684,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38.3185,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 52.2525,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 52.2525,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 55.736,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 52.2525,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 45.2855,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 52.2525,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 24.3845,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 40.4086,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 45.2855,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 45.2855,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 45.2855,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 55.736,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 55.736,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 45.2855,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.24097,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 22.85176,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.14668,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.40912,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.868,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 17.4175,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 55.046267,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.224161,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.941762,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.224161,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 54.941762,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 47.710016,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.344013,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 48.769,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 52.2525,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 45.2855,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 45.2855,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACOUSTIC IMMITANCE TESTING",
  "code_information": [
    {
      "code": "92570",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 26.84,
      "maximum": 474.97,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 165.495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 243.06,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 216.61,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 198.7981,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 397.188,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 234.20004,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 461.011356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 167.0331,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 198.594,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 273.23338,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 198.7981,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.84,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 198.7981,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 474.97065,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 218.67791,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 165.495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 268.377435,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 165.495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 218.67791,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 165.495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 165.495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 198.7981,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACOUSTIC REFL THRESHOLD TST",
  "code_information": [
    {
      "code": "92568",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 9.28,
      "maximum": 137.87,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.0396,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 60.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 54.34,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 49.8711,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 115.29504,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.12756,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 133.821636,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.4861,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 57.64752,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 70.14882,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 49.8711,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.28,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 49.8711,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 137.873652,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 54.85821,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.0396,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 67.325985,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.0396,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 54.85821,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.0396,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.0396,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 49.8711,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACROMP/ACROMIONECTOMY PRTL",
  "code_information": [
    {
      "code": "23130",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 4122.6,
      "maximum": 12077.93,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4208.339,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5040.72,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4492.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4122.6015,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10100.0136,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4853.05428,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11722.963656,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4247.4506,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5050.0068,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5661.89666,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4122.6015,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4122.6015,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12077.93293,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4534.86165,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4208.339,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5565.512025,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4208.339,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4534.86165,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4208.339,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4208.339,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4122.6015,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACTH STIMULATION PANEL",
  "code_information": [
    {
      "code": "80400",
      "type": "HCPCS"
    },
    {
      "code": "80402",
      "type": "HCPCS"
    },
    {
      "code": "80406",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 32.62,
      "maximum": 249.58,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 32.62,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 86.96,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 78.26,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 54.188344,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 144.457952,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 130.005512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 48.248242,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 128.622536,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 115.754366,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 32.62,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 86.96,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 78.26,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 78.288,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 208.704,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 187.824,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 39.144,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 104.352,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 93.912,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 90.0312,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 240.0096,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 215.9976,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 32.62,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 86.96,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 78.26,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 39.144,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 104.352,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 93.912,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 45.668,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 121.744,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 109.564,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 32.62,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 86.96,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 78.26,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.62,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.96,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 78.26,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 32.62,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 86.96,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 78.26,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 93.6194,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 249.5752,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 224.6062,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 35.882,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 95.656,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 86.086,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 32.62,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 86.96,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 78.26,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.037,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 117.396,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 105.651,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 32.62,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 86.96,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 78.26,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 35.882,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 95.656,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 86.086,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 32.62,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 86.96,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 78.26,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 32.62,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 86.96,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 78.26,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 32.62,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 86.96,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 78.26,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACTIDOSE WITH SORBITOL 25 GM/120ML PO SUSP",
  "drug_information": {
    "unit": 120.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "66689020304",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 10.05,
      "maximum": 36.16,
      "gross_charge": 40.18,
      "discounted_cash": 22.1,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.117,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.24204,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.045,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.153,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.153,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 32.429278,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 13.255382,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 11.776758,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.063,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 32.144,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 24.108,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.153,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.135,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.063,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.072,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.251522,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.251522,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.775952,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.3224,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 32.144,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.135,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11.2504,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.063,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.063,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.88492,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 33.9521,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25.7152,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 22.099,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.153,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34.153,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.135,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.2909,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.2909,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 22.5008,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.144,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.099,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.099,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.072,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.117,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.135,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.072,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.117,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.144,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.162,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29.138536,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.099,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.135,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.135,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.144,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.135,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.117,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.135,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.063,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.3044,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.117,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.117,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.117,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.144,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.144,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.117,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.71038,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.17904,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.23272,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.50048,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.072,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.045,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.746218,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.272094,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.685948,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.272094,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.685948,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.515264,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.880902,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.126,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.135,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.117,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.117,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACTIN ANTIBODY EACH",
  "code_information": [
    {
      "code": "86015",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 11.53,
      "maximum": 34.58,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.05,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.01746,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 17.823155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.05,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 28.92,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.46,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 33.258,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.05,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.46,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.05,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11.53,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.05,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34.5835,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13.255,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.05,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.2675,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.05,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13.255,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.05,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.05,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.05,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACTINOTHERAPY UV LIGHT",
  "code_information": [
    {
      "code": "96900",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 7.4,
      "maximum": 137.87,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.0396,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 60.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 54.34,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 49.8711,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 115.29504,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.12756,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 133.821636,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.4861,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 57.64752,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 70.14882,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 49.8711,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 49.8711,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 137.873652,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 54.85821,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.0396,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 67.325985,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.0396,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 54.85821,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.0396,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.0396,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 49.8711,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Activate matrix, per sq cm",
  "code_information": [
    {
      "code": "Q4301",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 160.06,
      "maximum": 459.36,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 384.1356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 445.861716,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 161.5441,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 192.0678,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 459.362155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACTIVE THRC IRRIGATION SPX",
  "code_information": [
    {
      "code": "1021T",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 806.82,
      "maximum": 2315.56,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 806.8164,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1936.35936,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2247.508848,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 814.3148,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 968.17968,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2315.563068,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 806.8164,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 806.8164,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 806.8164,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 806.8164,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACUP 1/> W/ESTIM 1ST 15 MIN",
  "code_information": [
    {
      "code": "97813",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 20.0,
      "maximum": 106.77,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.2005,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 38.05,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 33.91,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 31.117,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 89.2812,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.64324,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 103.627512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.5462,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.6406,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 52.08378,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 31.117,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 20.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 31.117,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 106.765435,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34.2287,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.2005,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 42.00795,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.2005,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34.2287,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.2005,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.2005,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 31.117,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACUP 1/> W/ESTIM EA ADDL 15",
  "code_information": [
    {
      "code": "97814",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 20.0,
      "maximum": 20.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 20.0,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION",
  "code_information": [
    {
      "code": "880",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 23934.68,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11418.91,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13629.0788,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12100.4404,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11418.91,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16012.640872,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10113.248888,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11418.91,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14704.44,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11798.783968,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23934.684554,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16783.76,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11189.17,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12308.09,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11418.91,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11418.91,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12308.09,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11418.91,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11189.17,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACUTE AND SUBACUTE ENDOCARDITIS WITH CC",
  "code_information": [
    {
      "code": "289",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 42547.5,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19975.82,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 24227.7386,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 21510.3538,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19975.82,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 28464.878884,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 17977.821836,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19975.82,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 26139.36,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 20974.114096,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 42547.503713,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27279.48,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 18186.32,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 20004.95,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19975.82,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19975.82,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 20004.95,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19975.82,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18186.32,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC",
  "code_information": [
    {
      "code": "288",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 67456.82,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 31427.43,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38411.8028,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34103.5324,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 31427.43,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 45129.565432,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 28502.889128,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 31427.43,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 41442.58,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 33253.352608,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 67456.824974,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 46888.71,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31259.13,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34385.05,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 31427.43,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 31427.43,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34385.05,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 31427.43,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 31259.13,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC",
  "code_information": [
    {
      "code": "290",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 23174.42,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11069.39,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13196.1618,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11716.0794,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11069.39,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 15504.011892,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9792.009468,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11069.39,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14237.37,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11424.004848,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23174.418069,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17130.16,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11420.1,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12562.12,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11069.39,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11069.39,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12562.12,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11069.39,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11420.1,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACUTE GI BLOOD LOSS IMAGING",
  "code_information": [
    {
      "code": "78278",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 129.8,
      "maximum": 1475.68,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 514.1725,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 624.27,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 556.32,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 510.5652,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1234.014,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 618.38076,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1432.305312,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 518.9512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 617.007,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 721.44422,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 510.5652,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 129.8,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 510.5652,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1475.675075,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 561.62172,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 514.1725,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 689.26302,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 514.1725,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 561.62172,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 514.1725,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 514.1725,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 510.5652,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACUTE HEPATITIS PANEL",
  "code_information": [
    {
      "code": "80074",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 41.79,
      "maximum": 136.7,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 47.63,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 79.122956,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 70.449533,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 47.63,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 114.312,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 57.156,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 131.4588,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 47.63,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 57.156,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 66.682,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 47.63,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 41.79,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 47.63,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 136.6981,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 52.393,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 47.63,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 64.3005,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 47.63,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 52.393,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 47.63,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 47.63,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 47.63,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACUTE LEUKEMIA WITH CC",
  "code_information": [
    {
      "code": "835",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 21968.56,
      "maximum": 51992.26,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 24317.88,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 24317.88,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 24317.88,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 31941.81,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36775.05,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 24516.69,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 26968.37,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 24317.88,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 24317.88,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 26968.37,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 24317.88,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 24516.69,
          "count": "0",
          "methodology": "case rate"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACUTE LEUKEMIA WITH MCC",
  "code_information": [
    {
      "code": "834",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 57822.04,
      "maximum": 136845.47,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 63327.62,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 63327.62,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 63327.62,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 84071.99,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 94363.14,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 62908.75,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 69199.63,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 63327.62,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 63327.62,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 69199.63,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 63327.62,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 62908.75,
          "count": "0",
          "methodology": "case rate"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACUTE LEUKEMIA WITH OTHER PROCEDURES",
  "code_information": [
    {
      "code": "850",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 91205.66,
      "maximum": 215853.36,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 99650.08,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 122912.943,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 109127.019,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 99650.08,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 144408.93942,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 91205.66418,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 99650.08,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 132611.06,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 106406.55048,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 215853.364815,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 156929.95,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 104619.96,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 115081.96,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 99650.08,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 99650.08,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 115081.96,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 99650.08,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 104619.96,
          "count": "0",
          "methodology": "case rate"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACUTE LEUKEMIA WITHOUT CC/MCC",
  "code_information": [
    {
      "code": "836",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 12844.31,
      "maximum": 30398.2,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14390.39,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14390.39,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14390.39,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18675.34,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 22083.41,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14722.27,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16194.5,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14390.39,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14390.39,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16194.5,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14390.39,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14722.27,
          "count": "0",
          "methodology": "case rate"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH CC",
  "code_information": [
    {
      "code": "835",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 51992.26,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29605.8452,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26285.2516,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34783.551688,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21968.563352,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25629.976672,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 51992.256866,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH MCC",
  "code_information": [
    {
      "code": "834",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 136845.47,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 77923.6406,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 69183.7198,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 91551.548764,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 57822.042356,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 67459.012816,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 136845.474623,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITHOUT CC/MCC",
  "code_information": [
    {
      "code": "836",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 30398.2,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17309.583,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15368.139,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 20336.82102,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12844.31058,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14985.02088,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 30398.196015,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACUTE MAJOR EYE INFECTIONS WITH CC/MCC",
  "code_information": [
    {
      "code": "121",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 28997.31,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13746.36,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16511.8802,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14659.9066,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13746.36,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19399.609588,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12252.387452,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13746.36,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 17814.7,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14294.444272,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 28997.311541,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 20257.99,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13505.32,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14855.86,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13746.36,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13746.36,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14855.86,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13746.36,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13505.32,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC",
  "code_information": [
    {
      "code": "122",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 19587.46,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9420.35,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11153.6452,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9902.6516,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9420.35,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13104.283688,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8276.391352,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9420.35,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12033.69,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9655.784672,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19587.455866,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12024.09,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8016.06,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8817.67,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9420.35,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9420.35,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8817.67,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9420.35,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8016.06,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC",
  "code_information": [
    {
      "code": "281",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 22910.19,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10947.92,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13045.7054,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11582.4982,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10947.92,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 15327.242476,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9680.365604,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10947.92,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14075.04,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11293.753744,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22910.194307,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16158.87,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10772.58,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11849.84,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10947.92,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10947.92,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11849.84,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10947.92,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10772.58,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC",
  "code_information": [
    {
      "code": "280",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 39985.03,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18797.77,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 22768.5954,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 20214.8682,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18797.77,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 26750.549076,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16895.087004,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18797.77,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 24565.09,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19710.924144,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 39985.031757,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28378.13,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 18918.75,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 20810.63,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18797.77,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18797.77,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 20810.63,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18797.77,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18918.75,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC",
  "code_information": [
    {
      "code": "282",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 18024.55,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8701.83,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10263.6814,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9112.5062,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8701.83,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12058.675916,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7616.007364,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8701.83,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11073.51,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8885.337104,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18024.547387,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12818.78,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8545.85,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9400.44,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8701.83,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8701.83,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9400.44,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8701.83,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8545.85,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC",
  "code_information": [
    {
      "code": "284",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 17254.31,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8347.73,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9825.0868,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8723.1044,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8347.73,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11543.376392,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7290.554968,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8347.73,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10600.3,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8505.642848,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 17254.310194,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13088.78,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8725.85,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9598.44,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8347.73,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8347.73,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9598.44,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8347.73,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8725.85,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC",
  "code_information": [
    {
      "code": "283",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 49374.95,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23114.61,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28115.4752,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 24962.0416,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23114.61,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 33032.533888,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 20862.657152,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23114.61,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 30333.85,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 24339.753472,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 49374.946016,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33710.05,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 22473.36,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 24720.7,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23114.61,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23114.61,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 24720.7,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23114.61,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22473.36,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC",
  "code_information": [
    {
      "code": "285",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 14928.64,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7278.54,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8500.7866,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7547.3378,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7278.54,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9987.472004,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6307.878316,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7278.54,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9171.51,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7359.187376,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14928.642553,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10039.06,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6692.7,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7361.97,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7278.54,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7278.54,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7361.97,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7278.54,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6692.7,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACUTE VENOUS THROMBUS IMAGE",
  "code_information": [
    {
      "code": "78456",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 148.64,
      "maximum": 4778.94,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1665.1344,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2028.15,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1807.37,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1658.7429,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3996.32256,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2128.98144,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4638.483324,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1680.6099,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1998.16128,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2483.81168,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1658.7429,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 148.64,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1658.7429,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4778.935728,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1824.61719,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1665.1344,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2239.302915,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1665.1344,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1824.61719,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1665.1344,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1665.1344,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1658.7429,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACYCLOVIR 200 MG PO CAPS",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00904578961",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.0,
      "maximum": 3.6,
      "gross_charge": 4.0,
      "discounted_cash": 2.2,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.712,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.2284,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.3196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.1724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.4,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.72,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.12,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.776,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.38,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.56,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.24,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.9008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.32,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.564,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.312,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.616,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.344,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACYCLOVIR 200 MG/5ML PO SUSP",
  "drug_information": {
    "unit": 5.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "2315548551",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.0,
      "maximum": 3.6,
      "gross_charge": 4.0,
      "discounted_cash": 2.2,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.712,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.2284,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.3196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.1724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.4,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.72,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.12,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.776,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.38,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.56,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.24,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.9008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.32,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.564,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.312,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.616,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.344,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACYCLOVIR 400 MG PO TABS",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "50268006115",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.0,
      "maximum": 3.6,
      "gross_charge": 4.0,
      "discounted_cash": 2.2,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.712,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.2284,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.3196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.1724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.4,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.72,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.12,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.776,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.38,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.56,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.24,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.9008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.32,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.564,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.312,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.616,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.344,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACYCLOVIR 5 % EX OINT",
  "drug_information": {
    "unit": 15.0,
    "type": "GR"
  },
  "code_information": [
    {
      "code": "72578008201",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 8.99,
      "maximum": 32.36,
      "gross_charge": 35.95,
      "discounted_cash": 19.77,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.3675,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 24.3741,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.9875,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.5575,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.5575,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 29.015245,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 11.859905,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 10.536945,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 21.57,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 28.76,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.5825,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.5575,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.9625,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12.5825,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.38,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.066755,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.066755,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 24.446,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.95708,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 28.76,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.9625,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.066,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12.5825,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12.5825,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 24.9493,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 30.37775,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23.008,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19.7725,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.5575,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 30.5575,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.9625,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 18.15475,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 18.15475,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 20.132,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.76,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19.7725,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19.7725,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.38,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.3675,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.9625,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.38,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23.3675,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.76,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.355,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.07094,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19.7725,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.9625,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.9625,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.76,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.9625,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.3675,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.9625,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.5825,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 20.851,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.3675,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.3675,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.3675,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.76,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.76,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.3675,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.05645,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11.7916,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.5238,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12.0792,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.38,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.9875,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.404095,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.979885,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.35017,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.979885,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.35017,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 24.61856,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 24.945705,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.165,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.9625,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.3675,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.3675,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACYCLOVIR 800 MG PO TABS",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "68084010901",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.0,
      "maximum": 3.6,
      "gross_charge": 4.0,
      "discounted_cash": 2.2,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.712,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.2284,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.3196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.1724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.4,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0116,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.72,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.12,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.776,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.38,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.56,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.4,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2.24,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.02,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.9008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2.2,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.4,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.32,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.564,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.312,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.616,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.344,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.1544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.7756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2.6,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACYCLOVIR SODIUM 50 MG/ML IV SOLN",
  "drug_information": {
    "unit": 20.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "55150015520",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 0.12,
      "maximum": 237.87,
      "gross_charge": 47.55,
      "discounted_cash": 26.15,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.9075,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 32.2389,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.8875,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 40.4175,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 40.4175,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 237.868875,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 15.686745,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 13.936905,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 0.119,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.6425,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 0.119,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 40.4175,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 35.6625,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.6425,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19.02,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 27.821505,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 27.821505,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.68732,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.334,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 38.04,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 35.6625,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.314,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.6425,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.6425,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 32.9997,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 40.17975,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 30.432,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.1525,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 40.4175,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 40.4175,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 35.6625,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 24.01275,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 24.01275,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 26.628,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.04,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 26.1525,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 26.1525,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.51,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.9075,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 35.6625,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19.02,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.9075,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.04,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 42.795,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.48326,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 26.1525,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 35.6625,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 35.6625,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.04,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 35.6625,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.9075,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 35.6625,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.6425,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.579,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.9075,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.9075,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.9075,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.04,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.04,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.9075,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 18.59205,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.5964,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19.2102,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.9768,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19.02,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.8875,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 37.569255,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 37.008165,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 37.49793,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 37.008165,
          "standard_charge_percentage": 77.83,
          "median_amount": 31.17,
          "10th_percentile": 31.17,
          "90th_percentile": 31.17,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 37.49793,
          "standard_charge_percentage": 78.86,
          "median_amount": 31.17,
          "10th_percentile": 31.17,
          "90th_percentile": 31.17,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.56224,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.994945,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.285,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 35.6625,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.9075,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.9075,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ACYLCARNITINES QUAL",
  "code_information": [
    {
      "code": "82016",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 13.19,
      "maximum": 47.33,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.49,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.393188,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 24.390359,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.49,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 39.576,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19.788,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 45.5124,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.49,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19.788,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23.086,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.49,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.19,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.49,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 47.3263,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.139,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.49,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.2615,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.49,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.139,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.49,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.49,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.49,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ACYLCARNITINES QUANT",
  "code_information": [
    {
      "code": "82017",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 14.99,
      "maximum": 48.42,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 28.024444,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 24.952417,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 40.488,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 20.244,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 46.5612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 20.244,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23.618,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.99,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.4169,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.557,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.7745,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.557,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.87,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ADALIMUMAB 20 MG/0.2ML SC PSKT",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00074061602",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 91.73,
      "maximum": 8464.26,
      "gross_charge": 9404.73,
      "discounted_cash": 5172.6,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6376.40694,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2351.1825,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7994.0205,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7994.0205,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 7590.557583,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 91.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 91.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 5642.838,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 91.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7994.0205,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3291.6555,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3761.892,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7080.821217,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7080.821217,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.69% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 6451.64478,
          "standard_charge_percentage": 68.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.70% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2633.3244,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3291.6555,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3291.6555,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6526.88262,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 7946.99685,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6019.0272,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5172.6015,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7994.0205,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7994.0205,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4749.38865,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4749.38865,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 5266.6488,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5172.6015,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 91.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3761.892,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3761.892,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 91.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8464.257,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6820.310196,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5172.6015,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 100.903,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5454.7434,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 123.8355,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 100.903,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3677.24943,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3084.75144,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3799.51092,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3159.98928,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3761.892,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2351.1825,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7430.677173,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7319.701359,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7416.570078,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 91.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7319.701359,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7416.570078,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6525.942147,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6440.359104,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ADALIMUMAB 40 MG/0.4ML SC PSKT",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00074024302",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 91.73,
      "maximum": 8464.26,
      "gross_charge": 9404.73,
      "discounted_cash": 5172.6,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6376.40694,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2351.1825,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7994.0205,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7994.0205,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 7590.557583,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 91.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 91.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 91.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 5642.838,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7994.0205,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3291.6555,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3761.892,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7080.821217,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7080.821217,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.69% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 6451.64478,
          "standard_charge_percentage": 68.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.70% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2633.3244,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3291.6555,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3291.6555,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6526.88262,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 7946.99685,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6019.0272,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5172.6015,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7994.0205,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7994.0205,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4749.38865,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4749.38865,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 5266.6488,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5172.6015,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 91.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3761.892,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3761.892,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 91.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8464.257,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6820.310196,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5172.6015,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 100.903,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5454.7434,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 123.8355,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 100.903,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3677.24943,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3084.75144,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3799.51092,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3159.98928,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3761.892,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2351.1825,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7430.677173,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7319.701359,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7416.570078,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 91.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7319.701359,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7416.570078,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6440.359104,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6525.942147,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ADALIMUMAB 40 MG/0.8ML SC AJKT",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00074433902",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 91.73,
      "maximum": 8464.26,
      "gross_charge": 9404.73,
      "discounted_cash": 5172.6,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6376.40694,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2351.1825,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7994.0205,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7994.0205,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 7590.557583,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 91.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 91.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 91.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 5642.838,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7994.0205,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3291.6555,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3761.892,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7080.821217,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7080.821217,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.69% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 6451.64478,
          "standard_charge_percentage": 68.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.70% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2633.3244,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3291.6555,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3291.6555,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6526.88262,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 7946.99685,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6019.0272,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5172.6015,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7994.0205,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7994.0205,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4749.38865,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4749.38865,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 5266.6488,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5172.6015,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 91.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3761.892,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3761.892,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 91.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8464.257,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6820.310196,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5172.6015,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 100.903,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5454.7434,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 123.8355,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 100.903,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3084.75144,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3677.24943,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3799.51092,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3159.98928,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3761.892,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2351.1825,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7430.677173,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7319.701359,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7416.570078,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 91.73,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7319.701359,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7416.570078,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6440.359104,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6525.942147,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ADALIMUMAB 40 MG/0.8ML SC PSKT",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00074379902",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2201.39,
      "maximum": 8464.26,
      "gross_charge": 9404.73,
      "discounted_cash": 5172.6,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6376.40694,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2351.1825,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7994.0205,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7994.0205,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 7590.557583,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3102.620427,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2756.526363,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 5642.838,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3291.6555,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7994.0205,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3291.6555,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2201.388,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3761.892,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7080.821217,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7080.821217,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.69% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 6451.64478,
          "standard_charge_percentage": 68.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.70% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2633.3244,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3291.6555,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3291.6555,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6526.88262,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 7946.99685,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6019.0272,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5172.6015,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7994.0205,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7994.0205,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4749.38865,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4749.38865,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 5266.6488,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2568.286,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5172.6015,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3761.892,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3761.892,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8464.257,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6820.310196,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5172.6015,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3291.6555,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5454.7434,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.784,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3677.24943,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3084.75144,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3799.51092,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3159.98928,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3761.892,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2351.1825,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7430.677173,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7319.701359,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7416.570078,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7319.701359,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7416.570078,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6440.359104,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6525.942147,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.311,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7053.5475,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6113.0745,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ADALIMUMAB 80 MG/0.8ML SC AJKT",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "00074012402",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2201.39,
      "maximum": 16928.56,
      "gross_charge": 18809.51,
      "discounted_cash": 10345.23,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12226.1815,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 12752.84778,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4702.3775,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15988.0835,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15988.0835,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 15181.155521,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6205.257349,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5513.067381,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 15047.608,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 11285.706,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6583.3285,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15988.0835,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14107.1325,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.3285,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2201.388,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.804,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14161.680079,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14161.680079,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.69% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 12903.32386,
          "standard_charge_percentage": 68.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.70% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 15047.608,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14107.1325,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5266.6628,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.3285,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6583.3285,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 13053.79994,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 15894.03595,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12038.0864,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10345.2305,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 15988.0835,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15988.0835,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14107.1325,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 9498.80255,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 9498.80255,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 10533.3256,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15047.608,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2568.286,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10345.2305,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.804,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12226.1815,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14107.1325,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.804,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15047.608,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12226.1815,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16928.559,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10345.2305,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13640.656652,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14107.1325,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14107.1325,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15047.608,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14107.1325,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12226.1815,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14107.1325,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6583.3285,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10909.5158,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12226.1815,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12226.1815,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12226.1815,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15047.608,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15047.608,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12226.1815,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7354.51841,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6169.51928,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7599.04204,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6319.99536,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7523.804,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4702.3775,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14861.393851,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14639.441633,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14833.179586,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14639.441633,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14833.179586,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12880.752448,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13051.918989,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13166.657,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14107.1325,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12226.1815,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12226.1815,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ADALIMUMAB-ATTO 40 MG/0.8ML SC SOAJ",
  "drug_information": {
    "unit": 0.8,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "72511040001",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1133.15,
      "maximum": 4079.35,
      "gross_charge": 4532.61,
      "discounted_cash": 2492.94,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2946.1965,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3073.10958,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1133.1525,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3852.7185,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3852.7185,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3658.269531,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1495.308039,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1328.507991,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2719.566,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1586.4135,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3626.088,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3852.7185,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3399.4575,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1586.4135,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1813.044,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3412.602069,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3412.602069,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.69% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 3109.37046,
          "standard_charge_percentage": 68.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.70% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 3626.088,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3399.4575,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1269.1308,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1586.4135,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1586.4135,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3145.63134,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3830.05545,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2900.8704,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2492.9355,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3852.7185,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3852.7185,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3399.4575,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2288.96805,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2288.96805,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2538.2616,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3626.088,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2492.9355,
          "standard_charge_percentage": 55.0,
          "median_amount": 18.06,
          "10th_percentile": 18.06,
          "90th_percentile": 18.06,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2492.9355,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1813.044,
          "standard_charge_percentage": 40.0,
          "median_amount": 18.06,
          "10th_percentile": 18.06,
          "90th_percentile": 18.06,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2946.1965,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3399.4575,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1813.044,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3626.088,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2946.1965,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4079.349,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2492.9355,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3287.048772,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3399.4575,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3399.4575,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3626.088,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3399.4575,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2946.1965,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3399.4575,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1586.4135,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2628.9138,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2946.1965,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2946.1965,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2946.1965,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3626.088,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3626.088,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2946.1965,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1772.25051,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1486.69608,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1831.17444,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1522.95696,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1813.044,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1133.1525,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3581.215161,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3527.730363,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3574.416246,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3527.730363,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3574.416246,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3103.931328,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3145.178079,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3172.827,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3399.4575,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2946.1965,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2946.1965,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ADAPT BEHAVIOR TX PHYS/QHP",
  "code_information": [
    {
      "code": "97155",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 204.15,
      "maximum": 655.19,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 228.2889,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 249.62,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 222.44,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 204.1473,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 547.89336,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 239.04684,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 635.933256,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 230.4106,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 273.94668,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 278.88798,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 204.1473,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 204.1473,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 655.189143,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 224.56203,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 228.2889,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 275.598855,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 228.2889,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 224.56203,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 228.2889,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 228.2889,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 204.1473,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ADAPT BHV TX EA 15 MIN",
  "code_information": [
    {
      "code": "0373T",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 37.85,
      "maximum": 138.31,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.1907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 46.28,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 41.24,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.8512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 115.65768,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 43.0224,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 134.242536,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.6386,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 57.82884,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 50.1928,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.8512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.8512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 138.307309,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 41.63632,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.1907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 51.09912,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.1907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 41.63632,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.1907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.1907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.8512,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ADAPTIVE BEHAVIOR TX BY TECH",
  "code_information": [
    {
      "code": "97153",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 117.53,
      "maximum": 375.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 130.6612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 143.71,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 128.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 117.5305,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 313.58688,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 133.64652,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 363.976656,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 131.8756,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 156.79344,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 155.92094,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 117.5305,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 117.5305,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 374.997644,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 129.28355,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 130.6612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 158.666175,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 130.6612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 129.28355,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 130.6612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 130.6612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 117.5305,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Add low ext mec limb vol sys",
  "code_information": [
    {
      "code": "L5783",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 5130.28,
      "maximum": 5130.28,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5130.28396,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Add proc construct new crown",
  "code_information": [
    {
      "code": "D2971",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 831.49,
      "maximum": 2851.93,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 831.4909,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2583.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2301.82,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2112.5377,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1995.57816,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1320.09972,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2316.243336,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 839.2186,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 997.78908,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1540.11634,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2112.5377,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2112.5377,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2386.378883,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2323.79147,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 831.4909,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2851.925895,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 831.4909,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2323.79147,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 831.4909,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 831.4909,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2112.5377,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Add pwr joystick",
  "code_information": [
    {
      "code": "E0983",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 553.73,
      "maximum": 2862.96,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 553.727796,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2862.96,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Add pwr leg elevation",
  "code_information": [
    {
      "code": "E1010",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 196.76,
      "maximum": 1143.79,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 225.059376,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 196.764673,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1143.79,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Add pwr tiller",
  "code_information": [
    {
      "code": "E0984",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 376.91,
      "maximum": 1623.99,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 376.909668,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1623.99,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Add to upp extr user adj mec",
  "code_information": [
    {
      "code": "L7406",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 5130.28,
      "maximum": 5130.28,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5130.28396,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "ADDING WALKER TO PREV CAST",
  "code_information": [
    {
      "code": "29440",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 200.49,
      "maximum": 599.84,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 209.0026,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 245.14,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 218.46,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 200.488,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 501.60624,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 236.2458,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 582.2082,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 210.945,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 250.80312,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 275.6201,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 200.488,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 200.488,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 599.837462,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 220.5368,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 209.0026,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 270.6588,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 209.0026,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 220.5368,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 209.0026,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 209.0026,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 200.488,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Addition endoskletl knee-shi",
  "code_information": [
    {
      "code": "L5841",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 6219.6,
      "maximum": 6219.6,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6219.599248,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "ADEFOVIR DIPIVOXIL 10 MG PO TABS",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "42794000308",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 12.39,
      "maximum": 44.61,
      "gross_charge": 49.57,
      "discounted_cash": 27.26,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.2205,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 33.60846,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.3925,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 42.1345,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 42.1345,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 40.007947,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 16.353143,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 14.528967,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 17.3495,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 29.742,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 39.656,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 42.1345,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 37.1775,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17.3495,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19.828,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 37.321253,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 37.321253,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.033448,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.7076,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 39.656,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 37.1775,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.8796,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17.3495,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17.3495,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 34.40158,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 41.88665,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 31.7248,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.2635,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 42.1345,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 42.1345,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 37.1775,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 25.03285,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 25.03285,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 27.7592,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 39.656,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 27.2635,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 27.2635,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19.828,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.2205,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 37.1775,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19.828,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.2205,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 39.656,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 44.613,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 27.2635,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 35.948164,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 37.1775,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 37.1775,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 39.656,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 37.1775,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.2205,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 37.1775,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 17.3495,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.7506,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.2205,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.2205,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.2205,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 39.656,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 39.656,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.2205,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.25896,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19.38187,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.65552,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 20.02628,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19.828,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.3925,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 39.165257,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.580331,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 39.090902,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 38.580331,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 39.090902,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 33.945536,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.396623,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.699,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 37.1775,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.2205,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.2205,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ADENOSINE (DIAGNOSTIC) 3 MG/ML IV SOLN",
  "drug_information": {
    "unit": 30.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "55150019301",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.89,
      "maximum": 2267.73,
      "gross_charge": 453.32,
      "discounted_cash": 249.33,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 294.658,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 307.35096,
          "standard_charge_percentage": 67.8,
          "median_amount": 29.68,
          "10th_percentile": 29.32,
          "90th_percentile": 30.03,
          "count": "12",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 113.33,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 385.322,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 385.322,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 2267.7333,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 149.550268,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 132.868092,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.887,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.887,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 158.662,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 385.322,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 339.99,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 158.662,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.328,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 265.237532,
          "standard_charge_percentage": 58.51,
          "median_amount": 25.24,
          "10th_percentile": 25.24,
          "90th_percentile": 25.24,
          "count": "25",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 265.237532,
          "standard_charge_percentage": 58.51,
          "median_amount": 25.24,
          "10th_percentile": 25.24,
          "90th_percentile": 25.24,
          "count": "68",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.69% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 310.97752,
          "standard_charge_percentage": 68.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.70% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 362.656,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 339.99,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 126.9296,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 158.662,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 158.662,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 314.60408,
          "standard_charge_percentage": 69.4,
          "median_amount": 28.97,
          "10th_percentile": 28.97,
          "90th_percentile": 28.97,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 383.0554,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 290.1248,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 249.326,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 385.322,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 385.322,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 339.99,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 228.9266,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 228.9266,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 253.8592,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 362.656,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 249.326,
          "standard_charge_percentage": 55.0,
          "median_amount": 41.55,
          "10th_percentile": 12.21,
          "90th_percentile": 48.0,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 249.326,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 294.658,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 339.99,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.328,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 294.658,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 362.656,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 407.988,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 328.747664,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 249.326,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 339.99,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 339.99,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 362.656,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 339.99,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 294.658,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 339.99,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 158.662,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 262.9256,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 294.658,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 294.658,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 294.658,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 362.656,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 362.656,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 294.658,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 177.24812,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 148.68896,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 183.14128,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 152.31552,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.328,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 113.33,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 358.168132,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 352.818956,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 357.488152,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 352.818956,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 357.488152,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 310.433536,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 314.558748,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 317.324,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 339.99,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 294.658,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 294.658,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ADENOSINE 6 MG/2ML IV SOLN",
  "drug_information": {
    "unit": 2.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "67457085502",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.89,
      "maximum": 200.1,
      "gross_charge": 40.0,
      "discounted_cash": 22.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.12,
          "standard_charge_percentage": 67.8,
          "median_amount": 29.68,
          "10th_percentile": 29.32,
          "90th_percentile": 30.03,
          "count": "12",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 200.1,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 13.196,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 11.724,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.887,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1.887,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 23.404,
          "standard_charge_percentage": 58.51,
          "median_amount": 25.24,
          "10th_percentile": 25.24,
          "90th_percentile": 25.24,
          "count": "68",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 23.404,
          "standard_charge_percentage": 58.51,
          "median_amount": 25.24,
          "10th_percentile": 25.24,
          "90th_percentile": 25.24,
          "count": "25",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.656,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.2,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11.2,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 27.76,
          "standard_charge_percentage": 69.4,
          "median_amount": 28.97,
          "10th_percentile": 28.97,
          "90th_percentile": 28.97,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 33.8,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25.6,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34.0,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.2,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 22.4,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 20.2,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "median_amount": 41.55,
          "10th_percentile": 12.21,
          "90th_percentile": 48.0,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 36.0,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 29.008,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.0,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.0,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23.2,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15.64,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.12,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13.44,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.16,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.0,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.604,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.132,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31.544,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.756,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27.392,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 28.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 30.0,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26.0,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ADENOVIRUS AG IA",
  "code_information": [
    {
      "code": "87301",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 10.1,
      "maximum": 34.38,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 19.901176,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 17.719618,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 28.752,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.376,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 33.0648,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.376,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.772,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.1,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34.3826,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13.178,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.173,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13.178,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.98,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ADENOVIRUS AG IF",
  "code_information": [
    {
      "code": "87260",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 10.1,
      "maximum": 41.41,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.43,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 23.971116,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 21.343413,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.43,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34.632,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 17.316,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 39.8268,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.43,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 17.316,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 20.202,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.43,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.1,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.43,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 41.4141,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 15.873,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.43,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19.4805,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.43,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 15.873,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.43,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.43,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.43,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ADENOVIRUS ANTIBODY",
  "code_information": [
    {
      "code": "86603",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 11.44,
      "maximum": 36.94,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 21.379644,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 19.036017,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 30.888,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 15.444,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 35.5212,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 15.444,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18.018,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11.44,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 36.9369,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.157,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 17.3745,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.157,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.87,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ADENOVIRUS ASSAY W/OPTIC",
  "code_information": [
    {
      "code": "87809",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 10.1,
      "maximum": 62.45,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 36.147712,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 32.185216,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 52.224,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 26.112,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.0576,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 26.112,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 30.464,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.1,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 62.4512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23.936,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 29.376,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23.936,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.76,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.76,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ADENOVIRUS VACCINE TYPE 4",
  "code_information": [
    {
      "code": "90476",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 55.2,
      "maximum": 64.4,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 55.2,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 64.4,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Adhesive clip ext ens contr",
  "code_information": [
    {
      "code": "A4438",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 3.21,
      "maximum": 3.21,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.206116,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adhesive remover per ounce",
  "code_information": [
    {
      "code": "A4455",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 3.31,
      "maximum": 3.31,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.305788,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adhesive remover, wipes",
  "code_information": [
    {
      "code": "A4456",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 0.56,
      "maximum": 0.56,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 0.564808,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adhesive, liquid or equal",
  "code_information": [
    {
      "code": "A4364",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 5.8,
      "maximum": 5.8,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5.797588,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adj shoulder ext/flex device",
  "code_information": [
    {
      "code": "E1840",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 872.69,
      "maximum": 872.69,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 872.694808,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adj skin pro w/c cus wd<22in",
  "code_information": [
    {
      "code": "E2622",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 56.01,
      "maximum": 299.68,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 62.87642,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 56.013517,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 299.68,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adj skin pro wc cus wd>=22in",
  "code_information": [
    {
      "code": "E2623",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 71.06,
      "maximum": 381.33,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 79.521644,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 71.055964,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 381.33,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adj skin pro/pos cus<22in",
  "code_information": [
    {
      "code": "E2624",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 56.69,
      "maximum": 302.14,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 63.906364,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 56.693903,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 302.14,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adj skin pro/pos wc cus>=22",
  "code_information": [
    {
      "code": "E2625",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 70.97,
      "maximum": 382.49,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 79.089732,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 70.967218,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 382.49,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "ADJMT/REVJ EXT FIXJ SYS ANES",
  "code_information": [
    {
      "code": "20693",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 9076.82,
      "maximum": 26784.86,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9332.7041,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 11098.26,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 9890.14,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9076.8233,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22398.48984,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10726.23144,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25997.656056,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9419.4406,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11199.24492,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12513.93668,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9076.8233,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9076.8233,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 26784.860767,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9984.50563,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9332.7041,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12253.711455,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9332.7041,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9984.50563,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9332.7041,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9332.7041,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9076.8233,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Adju cgm receiver/monitor",
  "code_information": [
    {
      "code": "E2102",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 38.96,
      "maximum": 38.96,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 38.95514,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adju cgm supply allowance",
  "code_information": [
    {
      "code": "A4238",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 457.18,
      "maximum": 457.18,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 457.178852,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adjust ankle ext & flex dev",
  "code_information": [
    {
      "code": "E1815",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 293.27,
      "maximum": 293.27,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 293.268248,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adjust ankle extension dev",
  "code_information": [
    {
      "code": "E1822",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 293.27,
      "maximum": 293.27,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 293.268248,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adjust ankle flexion device",
  "code_information": [
    {
      "code": "E1823",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 293.27,
      "maximum": 293.27,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 293.268248,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adjust elbow ext & flex dev",
  "code_information": [
    {
      "code": "E1800",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 284.33,
      "maximum": 284.33,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 284.330992,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adjust elbow extension dev",
  "code_information": [
    {
      "code": "E1803",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 284.33,
      "maximum": 284.33,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 284.330992,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adjust elbow flexion dev",
  "code_information": [
    {
      "code": "E1804",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 284.33,
      "maximum": 284.33,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 284.330992,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adjust finger ext & flex dev",
  "code_information": [
    {
      "code": "E1825",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 293.27,
      "maximum": 293.27,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 293.268248,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adjust finger extension dev",
  "code_information": [
    {
      "code": "E1826",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 293.27,
      "maximum": 293.27,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 293.268248,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adjust finger flexion device",
  "code_information": [
    {
      "code": "E1827",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 293.27,
      "maximum": 293.27,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 293.268248,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adjust knee ext & flex dev",
  "code_information": [
    {
      "code": "E1810",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 289.18,
      "maximum": 1195.97,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 289.181696,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1195.97,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adjust knee extension device",
  "code_information": [
    {
      "code": "E1813",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 289.18,
      "maximum": 289.18,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 289.181696,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adjust knee flexion device",
  "code_information": [
    {
      "code": "E1814",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 289.18,
      "maximum": 289.18,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 289.181696,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adjust toe ext & flex device",
  "code_information": [
    {
      "code": "E1830",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 293.27,
      "maximum": 293.27,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 293.268248,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adjust toe extension device",
  "code_information": [
    {
      "code": "E1828",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 293.27,
      "maximum": 293.27,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 293.268248,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adjust toe flexion device",
  "code_information": [
    {
      "code": "E1829",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 293.27,
      "maximum": 293.27,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 293.268248,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adjust wrist ext & flex dev",
  "code_information": [
    {
      "code": "E1805",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 293.27,
      "maximum": 293.27,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 293.268248,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adjust wrist extension dev",
  "code_information": [
    {
      "code": "E1807",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 293.27,
      "maximum": 293.27,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 293.268248,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adjust wrist flexion device",
  "code_information": [
    {
      "code": "E1808",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 293.27,
      "maximum": 293.27,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 293.268248,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adjustable angle footplate",
  "code_information": [
    {
      "code": "K0040",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 10.38,
      "maximum": 63.88,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 10.3825,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 11.300324,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 63.88,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Adm of soc dtr assess 5-15 m",
  "code_information": [
    {
      "code": "G0136",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 37.85,
      "maximum": 138.31,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.1907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 46.28,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 41.24,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.8512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 115.65768,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 43.0224,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 134.242536,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.6386,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 57.82884,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 50.1928,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.8512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.8512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 138.307309,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 41.63632,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.1907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 51.09912,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.1907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 41.63632,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.1907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.1907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.8512,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Adm tocilizu covid-19 1st",
  "code_information": [
    {
      "code": "M0249",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 450.5,
      "maximum": 1627.68,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 567.1345,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 450.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 450.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 572.4053,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1361.1228,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 708.91044,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1579.838628,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 572.4053,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 680.5614,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 827.06218,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 572.4053,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 572.4053,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1627.676015,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 629.64583,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 567.1345,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 772.747155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 567.1345,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 629.64583,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 567.1345,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 567.1345,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 572.4053,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Adm tocilizu covid-19 2nd",
  "code_information": [
    {
      "code": "M0250",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 450.5,
      "maximum": 1627.68,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 567.1345,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 450.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 450.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 572.4053,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1361.1228,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 708.91044,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1579.838628,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 572.4053,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 680.5614,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 827.06218,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 572.4053,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 572.4053,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1627.676015,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 629.64583,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 567.1345,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 772.747155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 567.1345,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 629.64583,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 567.1345,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 567.1345,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 572.4053,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ADMIN ECG CONTRAST AGENT",
  "code_information": [
    {
      "code": "93352",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 34.77,
      "maximum": 34.77,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 34.77,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "ADO-TRASTUZUMAB EMTANSINE 100 MG IV SOLR",
  "drug_information": {
    "unit": 5.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "50242008801",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2948.0,
      "maximum": 58989.53,
      "gross_charge": 11792.01,
      "discounted_cash": 6485.61,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7664.8065,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 7994.98278,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2948.0025,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10023.2085,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10023.2085,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 58989.530025,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3890.184099,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3456.238131,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 7075.206,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 9433.608,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4127.2035,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10023.2085,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8844.0075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4127.2035,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4716.804,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 6899.505051,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 6899.505051,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.70% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.69% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 8089.31886,
          "standard_charge_percentage": 68.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 9433.608,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8844.0075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3301.7628,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4127.2035,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4127.2035,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 8183.65494,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 9964.24845,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7546.8864,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6485.6055,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10023.2085,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10023.2085,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8844.0075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5954.96505,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5954.96505,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 6603.5256,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9433.608,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6485.6055,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6485.6055,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4716.804,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7664.8065,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8844.0075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4716.804,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7664.8065,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9433.608,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10612.809,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6485.6055,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8551.565652,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8844.0075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8844.0075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9433.608,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8844.0075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7664.8065,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8844.0075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4127.2035,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6839.3658,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7664.8065,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7664.8065,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7664.8065,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9433.608,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9433.608,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7664.8065,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4610.67591,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3867.77928,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3962.11536,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4763.97204,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4716.804,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2948.0025,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9316.867101,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9177.721383,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9299.179086,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9177.721383,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9299.179086,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8075.168448,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8182.475739,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8254.407,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8844.0075,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7664.8065,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7664.8065,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ADRC THER PRTL RC TEAR",
  "code_information": [
    {
      "code": "0717T",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 4557.82,
      "maximum": 13080.95,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4557.8223,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5687.56,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5068.42,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4651.6285,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10938.77352,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5379.00132,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12696.502044,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4600.1819,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5469.38676,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6275.50154,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4651.6285,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4651.6285,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13080.950001,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5116.79135,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4557.8223,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6279.698475,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4557.8223,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5116.79135,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4557.8223,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4557.8223,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4651.6285,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ADRC THER PRTL RC TEAR NJX",
  "code_information": [
    {
      "code": "0718T",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 4557.82,
      "maximum": 13080.95,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4557.8223,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5687.56,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5068.42,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4651.6285,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10938.77352,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5379.00132,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12696.502044,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4600.1819,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5469.38676,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6275.50154,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4651.6285,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4651.6285,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13080.950001,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5116.79135,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4557.8223,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6279.698475,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4557.8223,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5116.79135,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4557.8223,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4557.8223,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4651.6285,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC",
  "code_information": [
    {
      "code": "614",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 54634.49,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25532.6,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 31110.4092,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 27621.0636,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25532.6,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 36551.245848,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23085.001992,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25532.6,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 33565.09,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 26932.487712,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 54634.494486,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 39204.98,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26136.65,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 28750.32,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25532.6,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25532.6,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 28750.32,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25532.6,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 26136.65,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC",
  "code_information": [
    {
      "code": "615",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 34880.03,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16450.84,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19861.6642,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17633.9786,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16450.84,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23335.230548,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14738.043292,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16450.84,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21428.79,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 17194.374512,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34880.029261,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 24839.37,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16559.57,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18215.54,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16450.84,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16450.84,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18215.54,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16450.84,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16559.57,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ADRENAL CORTEX & MEDULLA IMG",
  "code_information": [
    {
      "code": "78075",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 217.82,
      "maximum": 4778.94,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1665.1344,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2028.15,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1807.37,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1658.7429,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3996.32256,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2128.98144,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4638.483324,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1680.6099,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1998.16128,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2483.81168,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1658.7429,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 217.82,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1658.7429,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4778.935728,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1824.61719,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1665.1344,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2239.302915,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1665.1344,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1824.61719,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1665.1344,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1665.1344,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1658.7429,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ADRNL CORTCL TUM BCHM ASY 25",
  "code_information": [
    {
      "code": "0015M",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1305.37,
      "maximum": 3746.41,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1305.37,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2168.480644,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1930.772767,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1305.37,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3132.888,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1566.444,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3602.8212,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1305.37,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1566.444,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1827.518,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1305.37,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1305.37,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3746.4119,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1435.907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1305.37,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1762.2495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1305.37,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1435.907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1305.37,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1305.37,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1305.37,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Adult BMT Autologous Transplant",
  "code_information": [
    {
      "code": "016-A",
      "type": "DRG"
    },
    {
      "code": "017-A",
      "type": "DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 271999.0,
      "maximum": 271999.0,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 271999.0,
          "count": "0",
          "methodology": "case rate"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ADULT TPN FEE (RX USE ONLY)",
  "drug_information": {
    "unit": 2000.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "9997088301",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 237.5,
      "maximum": 4752.38,
      "gross_charge": 950.0,
      "discounted_cash": 522.5,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 617.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 644.1,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 237.5,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 807.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 807.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 4752.375,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 313.405,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 278.445,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 760.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 332.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 570.0,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 807.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 712.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 332.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 380.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 555.845,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 555.845,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 646.0,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 633.08,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 760.0,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 712.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 266.0,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 332.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 332.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 659.3,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 802.75,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 608.0,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 522.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 807.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 807.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 712.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 479.75,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 479.75,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 532.0,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 760.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 522.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 522.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 380.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 617.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 712.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 380.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 617.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 760.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 855.0,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 522.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 688.94,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 712.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 712.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 760.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 712.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 617.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 712.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 332.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 551.0,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 617.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 617.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 617.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 760.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 760.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 617.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 371.45,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 311.6,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 383.8,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 319.2,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 380.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 237.5,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 750.595,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 739.385,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 749.17,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 739.385,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 749.17,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 650.56,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 659.205,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 665.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 712.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 617.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 617.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "Adv prim care mgmt lvl 1",
  "code_information": [
    {
      "code": "G0556",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 37.85,
      "maximum": 138.31,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.1907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 46.28,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 41.24,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.8512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 115.65768,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 134.242536,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.6386,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 57.82884,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.8512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.8512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 138.307309,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 41.63632,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.1907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 51.09912,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.1907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 41.63632,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.1907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.1907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.8512,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Adv prim care mgmt lvl 2",
  "code_information": [
    {
      "code": "G0557",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 37.85,
      "maximum": 138.31,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.1907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 46.28,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 41.24,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.8512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 115.65768,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 134.242536,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.6386,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 57.82884,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.8512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.8512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 138.307309,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 41.63632,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.1907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 51.09912,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.1907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 41.63632,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.1907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48.1907,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.8512,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Adv prim care mgmt lvl 3",
  "code_information": [
    {
      "code": "G0558",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 117.53,
      "maximum": 375.0,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 130.6612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 143.71,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 128.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 117.5305,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 313.58688,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 363.976656,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 131.8756,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 156.79344,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 117.5305,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 117.5305,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 374.997644,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 129.28355,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 130.6612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 158.666175,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 130.6612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 129.28355,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 130.6612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 130.6612,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 117.5305,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Advanced life support mileag",
  "code_information": [
    {
      "code": "A0390",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.3,
      "maximum": 1.3,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.3,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Advograft dual per sq cm",
  "code_information": [
    {
      "code": "Q4382",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 160.06,
      "maximum": 459.36,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 384.1356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 445.861716,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 161.5441,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 192.0678,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 459.362155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Advograft one per sq cm",
  "code_information": [
    {
      "code": "Q4380",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 160.06,
      "maximum": 459.36,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 384.1356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 445.861716,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 161.5441,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 192.0678,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 459.362155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Aed garment w elec analysis",
  "code_information": [
    {
      "code": "K0606",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 5844.98,
      "maximum": 5844.98,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5844.982036,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "AEP HEARING STATUS DETER I&R",
  "code_information": [
    {
      "code": "92651",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 80.62,
      "maximum": 797.04,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 277.7133,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 483.77,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 431.11,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 395.6648,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 666.51192,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 470.60316,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 773.612544,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 280.2944,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 333.25596,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 549.03702,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 395.6648,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 80.62,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 395.6648,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 797.037171,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 435.23128,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 277.7133,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 534.14748,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 277.7133,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 435.23128,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 277.7133,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 277.7133,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 395.6648,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AEP NEURODIAGNOSTIC I&R",
  "code_information": [
    {
      "code": "92653",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 76.92,
      "maximum": 797.04,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 277.7133,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 483.77,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 431.11,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 395.6648,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 666.51192,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 470.60316,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 773.612544,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 280.2944,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 333.25596,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 549.03702,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 395.6648,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 76.92,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 395.6648,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 797.037171,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 435.23128,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 277.7133,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 534.14748,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 277.7133,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 435.23128,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 277.7133,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 277.7133,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 395.6648,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AEP SCR AUDITORY POTENTIAL",
  "code_information": [
    {
      "code": "92650",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 25.68,
      "maximum": 25.68,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 25.68,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "AEP THRSHLD EST MLT FREQ I&R",
  "code_information": [
    {
      "code": "92652",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 104.64,
      "maximum": 797.04,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 277.7133,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 483.77,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 431.11,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 395.6648,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 666.51192,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 470.60316,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 773.612544,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 280.2944,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 333.25596,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 549.03702,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 395.6648,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 104.64,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 395.6648,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 797.037171,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 435.23128,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 277.7133,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 534.14748,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 277.7133,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 435.23128,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 277.7133,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 277.7133,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 395.6648,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Aeroguard per sq cm",
  "code_information": [
    {
      "code": "Q4370",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 160.06,
      "maximum": 459.36,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 384.1356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 445.861716,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 161.5441,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 192.0678,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 459.362155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Aerosol mask used w nebulize",
  "code_information": [
    {
      "code": "A7015",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1.79,
      "maximum": 3.12,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2.358904,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.120901,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1.79,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Afamelanotide implant, 1 mg",
  "code_information": [
    {
      "code": "J7352",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2423.63,
      "maximum": 8447.62,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2943.42,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2873.33,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2873.33,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3213.5865,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3213.5865,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2943.42,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7064.208,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3447.996,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8123.8392,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2943.42,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3532.104,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4022.662,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2873.33,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2423.63,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2873.33,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8447.6154,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3160.663,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2943.42,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3878.9955,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2943.42,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3160.663,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2943.42,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2943.42,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2873.33,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Afamitresgene autoleucel",
  "code_information": [
    {
      "code": "Q2057",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 741540.0,
      "maximum": 2211679.4,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 770620.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 741540.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 741540.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 770620.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1849488.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2126911.2,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 770620.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 924744.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2211679.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 770620.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 770620.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 770620.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 770620.0,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AFF2 GEN ALY DETC ABNL ALLEL",
  "code_information": [
    {
      "code": "81171",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 109.6,
      "maximum": 393.19,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 137.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 227.5844,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 202.6367,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 137.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 328.8,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 164.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 378.12,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 137.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 164.4,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 191.8,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 137.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 109.6,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 137.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 393.19,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 150.7,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 137.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 184.95,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 137.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 150.7,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 137.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 137.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 137.0,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AFF2 GEN ALYS CHARAC ALLELES",
  "code_information": [
    {
      "code": "81172",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 219.86,
      "maximum": 788.76,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 456.547596,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 406.501053,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 659.592,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 329.796,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 758.5308,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 329.796,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 384.762,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 219.86,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 788.7621,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 302.313,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 371.0205,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 302.313,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 274.83,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Affinity1 square cm",
  "code_information": [
    {
      "code": "Q4159",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 160.06,
      "maximum": 459.36,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 384.1356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 445.861716,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 161.5441,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 192.0678,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 175.45,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 459.362155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 160.0565,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AFLIBERCEPT 2 MG/0.05ML IZ SOLN",
  "drug_information": {
    "unit": 0.05,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "61755000502",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 763.9,
      "maximum": 18502.15,
      "gross_charge": 3698.58,
      "discounted_cash": 2034.22,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2404.077,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2507.63724,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 763.9,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3143.793,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3143.793,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 18502.14645,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 801.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 801.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 990.59,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 990.59,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 771.56,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3143.793,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2773.935,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1294.503,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1833.36,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1034.736,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1479.432,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 2164.039158,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 2164.039158,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.69% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 2537.22588,
          "standard_charge_percentage": 68.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.70% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2773.935,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 2958.864,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1035.6024,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1294.503,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1294.503,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2566.81452,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3125.3001,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2108.364,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 763.9,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2034.219,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3143.793,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 916.68,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2773.935,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1867.7829,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1867.7829,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2071.2048,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2958.864,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1207.192,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 821.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 872.7,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2404.077,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2773.935,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1479.432,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 821.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2404.077,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2958.864,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3328.722,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2682.210216,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2192.393,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2773.935,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2773.935,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2958.864,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2773.935,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2404.077,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2773.935,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 904.178,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2145.1764,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 763.9,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2404.077,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1109.673,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2404.077,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2404.077,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 763.9,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2958.864,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2958.864,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2404.077,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 904.178,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 763.9,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1446.14478,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1213.13424,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1494.22632,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1242.72288,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1479.432,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 763.9,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2922.248058,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2878.604814,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2916.700188,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 821.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2878.604814,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2916.700188,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2566.444662,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2532.787584,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2589.006,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2773.935,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2404.077,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2404.077,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "AFLIBERCEPT 2 MG/0.05ML IZ SOSY",
  "drug_information": {
    "unit": 0.05,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "61755000501",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 763.9,
      "maximum": 27763.88,
      "gross_charge": 5550.0,
      "discounted_cash": 3052.5,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3607.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3762.9,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 763.9,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4717.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4717.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 27763.875,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 801.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 801.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 990.59,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 771.56,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 990.59,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4717.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4162.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1942.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1833.36,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1034.736,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2220.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 3247.305,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 3247.305,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.69% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 3807.3,
          "standard_charge_percentage": 68.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.70% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 4440.0,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4162.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1554.0,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1942.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1942.5,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3851.7,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4689.75,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2108.364,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 763.9,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3052.5,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4717.5,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 916.68,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4162.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2802.75,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2802.75,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3108.0,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4440.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1207.192,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 821.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 872.7,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3607.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4162.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2220.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 821.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3607.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4440.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4995.0,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4024.86,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2192.393,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4162.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4162.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4440.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4162.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3607.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4162.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 904.178,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3219.0,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 763.9,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3607.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1109.673,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3607.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3607.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 763.9,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4440.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4440.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3607.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 904.178,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 763.9,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2170.05,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1820.4,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2242.2,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1864.8,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2220.0,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 763.9,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4385.055,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4319.565,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4376.73,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 821.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4319.565,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4376.73,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3800.64,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3851.145,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3885.0,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4162.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3607.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3607.5,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "AFLIBERCEPT 8 MG/0.07ML IZ SOLN",
  "drug_information": {
    "unit": 0.07,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "61755005001",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 306.98,
      "maximum": 29817.2,
      "gross_charge": 5960.46,
      "discounted_cash": 3278.25,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3874.299,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4041.19188,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 306.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5066.391,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5066.391,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 29817.20115,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 329.06,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 329.06,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 348.211,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 348.211,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 311.38,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5066.391,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4470.345,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2086.161,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 736.752,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2384.184,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 3487.465146,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 3487.465146,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.69% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 4088.87556,
          "standard_charge_percentage": 68.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.70% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 4768.368,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4470.345,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1668.9288,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2086.161,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2086.161,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4136.55924,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5036.5887,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 847.2648,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 306.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3278.253,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5066.391,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 368.376,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4470.345,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3010.0323,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3010.0323,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 3337.8576,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4768.368,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3278.253,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 333.7,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2384.184,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3874.299,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4470.345,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2384.184,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4768.368,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3874.299,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 333.7,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5364.414,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4322.525592,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 881.0326,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4470.345,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4470.345,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4768.368,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4470.345,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3874.299,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4470.345,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 367.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3457.0668,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 306.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3874.299,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 450.495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3874.299,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3874.299,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 306.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4768.368,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4768.368,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3874.299,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 367.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 306.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2330.53986,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1955.03088,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2408.02584,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2002.71456,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2384.184,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 306.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4709.359446,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4639.026018,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4700.418756,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 333.7,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4639.026018,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4700.418756,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4081.723008,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4135.963194,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4172.322,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4470.345,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3874.299,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3874.299,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "Afluria vacc, 3 yrs & >, im",
  "code_information": [
    {
      "code": "Q2035",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 16.32,
      "maximum": 16.32,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 16.32,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 16.32,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Afo sing upright w/ adjust s",
  "code_information": [
    {
      "code": "L1920",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 219.54,
      "maximum": 682.27,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 682.271452,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 219.54,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Afo spiral prefab ots",
  "code_information": [
    {
      "code": "L1952",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 1640.63,
      "maximum": 1640.63,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1640.634344,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Afo tib fx semi-rigid",
  "code_information": [
    {
      "code": "L2114",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 434.0,
      "maximum": 1448.37,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1448.367056,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 434.0,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Afo tibial fracture rigid",
  "code_information": [
    {
      "code": "L2116",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 477.58,
      "maximum": 1776.4,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1776.40422,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 477.58,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "AFTER CATARACT LASER SURGERY",
  "code_information": [
    {
      "code": "66821",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 697.05,
      "maximum": 2030.2,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 707.3885,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 852.29,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 759.51,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 697.0512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1697.7324,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 871.51128,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1970.537328,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 713.9628,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 848.8662,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1016.76316,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 697.0512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 697.0512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2030.204995,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 766.75632,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 707.3885,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 941.01912,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 707.3885,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 766.75632,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 707.3885,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 707.3885,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 697.0512,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AFTERCARE WITH CC/MCC",
  "code_information": [
    {
      "code": "949",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 29655.38,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14048.9,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16886.6018,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14992.5994,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14048.9,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19839.865492,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12530.443868,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14048.9,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18218.99,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14618.843248,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 29655.378269,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 18828.23,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12552.15,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13807.37,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14048.9,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14048.9,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13807.37,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14048.9,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12552.15,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AFTERCARE WITHOUT CC/MCC",
  "code_information": [
    {
      "code": "950",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 15646.53,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7608.58,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8909.5738,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7910.2754,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7608.58,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10467.751172,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6611.212588,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7608.58,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9612.56,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7713.077168,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 15646.533529,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10458.48,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6972.31,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7669.55,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7608.58,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7608.58,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7669.55,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7608.58,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6972.31,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC",
  "code_information": [
    {
      "code": "560",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 28070.04,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13320.06,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15983.8634,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14191.1122,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13320.06,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 18779.248996,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11860.580684,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13320.06,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 17245.02,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13837.336624,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 28070.035697,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19841.97,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 13227.97,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14550.78,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13320.06,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13320.06,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14550.78,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13320.06,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13227.97,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC",
  "code_information": [
    {
      "code": "559",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 46485.93,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21786.44,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 26470.3906,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 23501.4698,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21786.44,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 31099.743764,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19641.947356,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21786.44,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 28558.96,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22915.592816,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 46485.933373,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 32027.27,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 21351.51,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23486.66,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21786.44,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21786.44,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23486.66,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21786.44,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21351.51,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC",
  "code_information": [
    {
      "code": "561",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 20038.63,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9627.77,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11410.5566,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10130.7478,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9627.77,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13406.125804,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8467.028516,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9627.77,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12310.87,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9878.194576,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 20038.630403,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14389.49,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9592.99,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10552.29,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9627.77,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9627.77,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10552.29,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9627.77,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9592.99,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AG DETECTION POLYVAL IF",
  "code_information": [
    {
      "code": "87300",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 5.14,
      "maximum": 34.38,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 19.901176,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 17.719618,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 28.752,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.376,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 33.0648,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.376,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.772,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.14,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 34.3826,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13.178,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.173,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 13.178,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 11.98,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AGALSIDASE BETA 35 MG IV SOLR",
  "drug_information": {
    "unit": 7.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "58468004001",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 5591.05,
      "maximum": 111876.86,
      "gross_charge": 22364.19,
      "discounted_cash": 12300.3,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14536.7235,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 15162.92082,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5591.0475,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19009.5615,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19009.5615,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 111876.860475,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 7377.946281,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6554.944089,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7827.4665,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 15948.0,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 11961.0,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19009.5615,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16773.1425,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7827.4665,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8945.676,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 13085.287569,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 13085.287569,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.69% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 15341.83434,
          "standard_charge_percentage": 68.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.70% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 17891.352,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16773.1425,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 6261.9732,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7827.4665,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7827.4665,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 15520.74786,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 18897.74055,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14313.0816,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12300.3045,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19009.5615,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 19009.5615,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16773.1425,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 11293.91595,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 12523.9464,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 11293.91595,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17891.352,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12300.3045,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12300.3045,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8945.676,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14536.7235,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16773.1425,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8945.676,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17891.352,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14536.7235,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 20127.771,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16218.510588,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12300.3045,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16773.1425,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16773.1425,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17891.352,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16773.1425,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14536.7235,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16773.1425,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7827.4665,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 12971.2302,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14536.7235,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14536.7235,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14536.7235,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17891.352,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17891.352,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14536.7235,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8744.39829,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7335.45432,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9035.13276,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7514.36784,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8945.676,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5591.0475,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17669.946519,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17406.049077,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17636.400234,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17406.049077,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 17636.400234,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15314.997312,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15518.511441,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 15654.933,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 16773.1425,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14536.7235,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 14536.7235,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "AGALSIDASE BETA 5 MG IV SOLR",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "58468004101",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 798.59,
      "maximum": 15979.69,
      "gross_charge": 3194.34,
      "discounted_cash": 1756.89,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2076.321,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2165.76252,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 798.585,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2715.189,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2715.189,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold Can be subject to lesser of provisions",
          "standard_charge_dollar": 15979.68585,
          "standard_charge_percentage": 500.25,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1053.812766,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 936.261054,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 2555.472,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 1916.604,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1118.019,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2715.189,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2395.755,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1118.019,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1277.736,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 1869.008334,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 1869.008334,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.69% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 2191.31724,
          "standard_charge_percentage": 68.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at 0.70% of charge if it exceeds the contractual threshold of $250.00",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2395.755,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 2555.472,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 894.4152,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1118.019,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1118.019,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2216.87196,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 2699.2173,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2044.3776,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1756.887,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2715.189,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2715.189,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2395.755,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1613.1417,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 1788.8304,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1613.1417,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2555.472,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1756.887,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1756.887,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1277.736,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2076.321,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2395.755,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1277.736,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2076.321,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2555.472,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2874.906,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1756.887,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2316.535368,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2395.755,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2395.755,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2555.472,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2395.755,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2076.321,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2395.755,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1118.019,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1852.7172,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2076.321,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2076.321,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2076.321,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2555.472,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2555.472,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2076.321,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1248.98694,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1047.74352,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1290.51336,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1073.29824,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 1277.736,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 798.585,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2523.848034,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2486.154822,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2519.056524,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2486.154822,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2519.056524,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2187.484032,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2216.552526,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2236.038,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2395.755,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2076.321,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 2076.321,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "Agalsidase beta injection",
  "code_information": [
    {
      "code": "J0180",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 222.06,
      "maximum": 660.99,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 230.31,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 223.52,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 223.52,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 228.072,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 228.072,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 230.15,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 552.744,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 262.008,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 635.6556,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 230.31,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 276.372,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 305.676,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 223.52,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 222.06,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 223.52,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 660.9897,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 245.872,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 230.31,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 301.752,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 230.31,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 245.872,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 230.31,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 230.31,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 223.52,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AGENT NOS ASSAY W/OPTIC",
  "code_information": [
    {
      "code": "87899",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 4.87,
      "maximum": 46.12,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 26.695484,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 23.769137,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38.568,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19.284,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.3532,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19.284,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 22.498,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.87,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 46.1209,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 17.677,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.6945,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 17.677,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.07,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AGGLUTININS FEBRILE ANTIGEN",
  "code_information": [
    {
      "code": "86000",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 5.32,
      "maximum": 20.03,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 11.595176,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 10.324118,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 16.752,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.376,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 19.2648,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.376,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9.772,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.32,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 20.0326,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7.678,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 9.423,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7.678,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6.98,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6.98,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AI DS SLE ALYS 10 CYTOKINE",
  "code_information": [
    {
      "code": "0446U",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 840.65,
      "maximum": 2412.67,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1396.48778,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1243.405415,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2017.56,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2320.194,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1008.78,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2412.6655,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 924.715,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1134.8775,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 924.715,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AI DS SLE ALYS 11 CYTOKINE",
  "code_information": [
    {
      "code": "0447U",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 840.65,
      "maximum": 2412.67,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1396.48778,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1243.405415,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2017.56,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2320.194,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1008.78,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2412.6655,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 924.715,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1134.8775,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 924.715,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AI DS SLE ALYS 8 IGG AUTOANT",
  "code_information": [
    {
      "code": "0312U",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 840.65,
      "maximum": 2412.67,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1396.48778,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1243.405415,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2017.56,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1008.78,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2320.194,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1008.78,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1176.91,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2412.6655,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 924.715,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1134.8775,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 924.715,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 840.65,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AI IBD MRNA XPRSN PRFL 17",
  "code_information": [
    {
      "code": "0203U",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 760.0,
      "maximum": 2181.2,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 760.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1262.512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 1124.116,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 760.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1824.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 912.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2097.6,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 760.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 912.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1064.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 760.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 760.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 2181.2,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 836.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 760.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1026.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 760.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 836.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 760.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 760.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 760.0,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AI PSOR MRNA 50-100 GEN ALG",
  "code_information": [
    {
      "code": "0258U",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 3675.0,
      "maximum": 10547.25,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3675.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6104.91,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 5435.6925,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3675.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8820.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4410.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10143.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3675.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4410.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5145.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3675.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3675.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10547.25,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4042.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3675.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4961.25,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3675.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4042.5,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3675.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3675.0,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3675.0,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AI SLE IGG&IGM ALYS 80 BMRK",
  "code_information": [
    {
      "code": "0062U",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 380.72,
      "maximum": 1092.67,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 380.72,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 632.452064,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 563.122952,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 380.72,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 913.728,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 456.864,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1050.7872,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 380.72,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 456.864,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 533.008,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 380.72,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 380.72,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 1092.6664,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 418.792,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 380.72,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 513.972,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 380.72,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 418.792,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 380.72,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 380.72,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 380.72,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AICD generator procedures",
  "code_information": [
    {
      "code": "245",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 131258.0,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 131258.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 52698.81,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 21423.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 64758.7056,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 57495.3648,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to separate per diem based on day of stay",
          "standard_charge_dollar": 39861.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisionsCan be subject to separate per diem based on day of stay",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 52698.81,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to separate per diem based on day of stay",
          "standard_charge_dollar": 29896.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisionsCan be subject to separate per diem based on day of stay",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 76084.224864,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 48053.204256,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to separate per diem based on day of stay",
          "standard_charge_dollar": 64050.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisionsCan be subject to separate per diem based on day of stay",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to separate per diem based on day of stay",
          "standard_charge_dollar": 64050.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisionsCan be subject to separate per diem based on day of stay",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 22000.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 18600.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days, Can be subject to separate per diem based on day of stay",
          "standard_charge_dollar": 7581.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisionsCan be subject to separate per diem based on day of stay",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days, Can be subject to separate per diem based on day of stay",
          "standard_charge_dollar": 7429.38,
          "standard_charge_algorithm": "Can be subject to stoploss provisionsCan be subject to separate per diem based on day of stay",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to separate per diem based on day of stay",
          "standard_charge_dollar": 30939.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisionsCan be subject to separate per diem based on day of stay",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to separate per diem based on day of stay",
          "standard_charge_dollar": 82089.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisionsCan be subject to separate per diem based on day of stay",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 52698.81,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 36030.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 69868.31,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to separate per diem based on day of stay",
          "standard_charge_dollar": 40574.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisionsCan be subject to separate per diem based on day of stay",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 18600.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 22000.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 56062.041216,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 113725.895448,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 83487.05,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 55658.03,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 61223.84,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 52698.81,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 19000.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 17500.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 52698.81,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2500.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days, Can be subject to separate per diem based on day of stay",
          "standard_charge_dollar": 2800.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisionsCan be subject to separate per diem based on day of stay",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 61223.84,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 52698.81,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to separate per diem based on day of stay",
          "standard_charge_dollar": 92778.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisionsCan be subject to separate per diem based on day of stay",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 55658.03,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "AICD lead procedures",
  "code_information": [
    {
      "code": "265",
      "type": "MS-DRG"
    }
  ],
  "standard_charges": [
    {
      "minimum": 2175.0,
      "maximum": 92778.0,
      "setting": "inpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 41878.62,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 21423.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 51356.7308,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 45596.5564,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to separate per diem based on day of stay",
          "standard_charge_dollar": 39861.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisionsCan be subject to separate per diem based on day of stay",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to separate per diem based on day of stay",
          "standard_charge_dollar": 29896.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisionsCan be subject to separate per diem based on day of stay",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 41878.62,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60338.405752,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 38108.474408,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 6263.68,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to separate per diem based on day of stay",
          "standard_charge_dollar": 30939.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisionsCan be subject to separate per diem based on day of stay",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to separate per diem based on day of stay",
          "standard_charge_dollar": 82089.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisionsCan be subject to separate per diem based on day of stay",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 41878.62,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 55408.89,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44459.862688,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 90190.039214,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 61079.42,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 40719.61,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44791.57,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 41878.62,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 41878.62,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to additional per diem in excess of included days",
          "standard_charge_dollar": 2175.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "per diem"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44791.57,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 41878.62,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to stoploss provisions, Can be subject to separate per diem based on day of stay",
          "standard_charge_dollar": 92778.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisionsCan be subject to separate per diem based on day of stay",
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 40719.61,
          "count": "0",
          "methodology": "case rate"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available., This code and the associated base rate is considered to be an all inclusive rate which may include additional clinical services",
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "AIR DISPLACMNT PLETHYSMOGRAP",
  "code_information": [
    {
      "code": "1002T",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 37.2,
      "maximum": 106.77,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.2005,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 89.2812,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 103.627512,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.5462,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 44.6406,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 106.765435,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.2005,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.2005,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.2005,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 37.2005,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Air fluidized bed",
  "code_information": [
    {
      "code": "E0194",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 7365.53,
      "maximum": 7365.53,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 7365.528232,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Air pressure mattress",
  "code_information": [
    {
      "code": "E0186",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 38.34,
      "maximum": 194.88,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 38.656124,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 38.338272,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 194.88,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "Air pressure pad for mattres",
  "code_information": [
    {
      "code": "E0197",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 34.95,
      "maximum": 134.96,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 34.951648,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 48.174287,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 134.96,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "AIRWY RESIST BY OSCILLOMETRY",
  "code_information": [
    {
      "code": "94728",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 37.62,
      "maximum": 474.97,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 165.495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 243.06,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 216.61,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 198.7981,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 397.188,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 234.20004,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 461.011356,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 167.0331,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 198.594,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 273.23338,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 198.7981,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 37.62,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 198.7981,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 474.97065,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 218.67791,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 165.495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 268.377435,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 165.495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 218.67791,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 165.495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 165.495,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 198.7981,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Ak 4 bar link hydl swg/stanc",
  "code_information": [
    {
      "code": "L5615",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 14284.33,
      "maximum": 14284.33,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 14284.32656,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "Per Service Unit Rate"
    }
  ]
},
{
  "description": "ALANINE AMINO (ALT) (SGPT)",
  "code_information": [
    {
      "code": "84460",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 4.58,
      "maximum": 15.21,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.3,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 8.80436,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 7.83923,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.3,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.72,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6.36,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.628,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.3,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 6.36,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7.42,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.3,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.58,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.3,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 15.211,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.3,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7.155,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.3,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.83,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.3,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.3,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 5.3,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ALBENDAZOLE 200 MG PO TABS",
  "drug_information": {
    "unit": 1.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "43598045202",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 3.21,
      "maximum": 11.56,
      "gross_charge": 12.84,
      "discounted_cash": 7.06,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.346,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 8.70552,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.21,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.914,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.914,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 10.363164,
          "standard_charge_percentage": 80.71,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 4.235916,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 3.763404,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4.494,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 7.704,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 10.272,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.914,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.63,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.494,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.136,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.667236,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.667236,
          "standard_charge_percentage": 75.29,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.556576,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.7312,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 10.272,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.63,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 3.5952,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.494,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.494,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 8.91096,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 10.8498,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 8.2176,
          "standard_charge_percentage": 64.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.062,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.914,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.914,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.63,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6.4842,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 6.4842,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 7.1904,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.272,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7.062,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7.062,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.136,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.346,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.63,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.136,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.346,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.272,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 11.556,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 7.062,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.311568,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.63,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.63,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.272,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.63,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.346,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.63,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 4.494,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 7.4472,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.346,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.346,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.346,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.272,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.272,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.346,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.02044,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.21152,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.18736,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 4.31424,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 5.136,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 3.21,
          "standard_charge_percentage": 25.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.144884,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.993372,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.125624,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.993372,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.125624,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.792832,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.909676,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.988,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 9.63,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.346,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 8.346,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "Albumin (human), 25%, 20 ml",
  "code_information": [
    {
      "code": "P9046",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 21.23,
      "maximum": 60.93,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.23,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 21.23,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 21.23,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.23,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 50.952,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25.476,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 58.5948,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.23,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25.476,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 29.722,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.23,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 21.23,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.23,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 60.9301,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23.353,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.23,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 28.6605,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.23,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 23.353,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.23,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.23,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 21.23,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "Albumin (human),5%, 50ml",
  "code_information": [
    {
      "code": "P9041",
      "type": "HCPCS"
    }
  ],
  "standard_charges": [
    {
      "minimum": 10.61,
      "maximum": 30.45,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.61,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 25.464,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.744,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 29.2836,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.61,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 12.732,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 14.868,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 10.62,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 30.4507,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.61,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.61,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.61,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 10.61,
          "count": "0",
          "methodology": "fee schedule"
        }
      ],
      "additional_generic_notes": "No additional generic notes"
    }
  ]
},
{
  "description": "ALBUMIN HUMAN 25 % IV SOLN (MULTI-GPI)",
  "drug_information": {
    "unit": 50.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "68516521609",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 53.07,
      "maximum": 192.6,
      "gross_charge": 214.0,
      "discounted_cash": 117.7,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 145.092,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 170.4082,
          "standard_charge_percentage": 79.63,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 70.5986,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 62.7234,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 128.4,
          "standard_charge_percentage": 60.0,
          "median_amount": 255.94,
          "10th_percentile": 255.94,
          "90th_percentile": 255.94,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 127.368,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 63.696,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 125.2114,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 125.2114,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 142.6096,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 145.52,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 59.92,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 148.516,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 180.83,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 146.4732,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 117.7,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 63.684,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 108.07,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 108.07,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 119.84,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 74.312,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 117.7,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 192.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 152.3109,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 155.1928,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 124.12,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 83.674,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 70.192,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.456,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.904,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 169.0814,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 166.5562,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 168.7604,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 166.5562,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 168.7604,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 146.5472,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 148.4946,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ALBUMIN HUMAN 25 % IV SOLN (MULTI-GPI) HRS",
  "drug_information": {
    "unit": 50.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "68516521609_2",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 53.07,
      "maximum": 192.6,
      "gross_charge": 214.0,
      "discounted_cash": 117.7,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 145.092,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 170.4082,
          "standard_charge_percentage": 79.63,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 70.5986,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 62.7234,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 128.4,
          "standard_charge_percentage": 60.0,
          "median_amount": 255.94,
          "10th_percentile": 255.94,
          "90th_percentile": 255.94,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 127.368,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 63.696,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 125.2114,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 125.2114,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 142.6096,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 145.52,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 59.92,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 148.516,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 180.83,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 146.4732,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 117.7,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 63.684,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 108.07,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 119.84,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 108.07,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 74.312,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 117.7,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 192.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 155.1928,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 152.3109,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 124.12,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 83.674,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 70.192,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.456,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.904,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 169.0814,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 166.5562,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 168.7604,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 166.5562,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 168.7604,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 146.5472,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 148.4946,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ALBUMIN HUMAN 25 % IV SOLN 50ML VIAL (BULK CHARGE)",
  "drug_information": {
    "unit": 50.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "68516521609_3",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 53.07,
      "maximum": 192.6,
      "gross_charge": 214.0,
      "discounted_cash": 117.7,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 145.092,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 170.4082,
          "standard_charge_percentage": 79.63,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 70.5986,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 62.7234,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 128.4,
          "standard_charge_percentage": 60.0,
          "median_amount": 255.94,
          "10th_percentile": 255.94,
          "90th_percentile": 255.94,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 127.368,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 63.696,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 125.2114,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 125.2114,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 142.6096,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 145.52,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 59.92,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 148.516,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 180.83,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 146.4732,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 117.7,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 63.684,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 108.07,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 108.07,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 119.84,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 74.312,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 117.7,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 192.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 155.1928,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 152.3109,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 124.12,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 83.674,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 70.192,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.456,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.904,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 169.0814,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 166.5562,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 168.7604,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 166.5562,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 168.7604,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 146.5472,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 148.4946,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ALBUMIN HUMAN 25 % IV SOLN FOR REPLACEMENT FLUIDS",
  "drug_information": {
    "unit": 50.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "68516521609_4",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 53.07,
      "maximum": 192.6,
      "gross_charge": 214.0,
      "discounted_cash": 117.7,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 145.092,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 170.4082,
          "standard_charge_percentage": 79.63,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 70.5986,
          "standard_charge_percentage": 32.99,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 62.7234,
          "standard_charge_percentage": 29.31,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 128.4,
          "standard_charge_percentage": 60.0,
          "median_amount": 255.94,
          "10th_percentile": 255.94,
          "90th_percentile": 255.94,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 127.368,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 63.696,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 125.2114,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 125.2114,
          "standard_charge_percentage": 58.51,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 142.6096,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 145.52,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 59.92,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 148.516,
          "standard_charge_percentage": 69.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 180.83,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 146.4732,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 117.7,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 63.684,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 108.07,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 108.07,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 119.84,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 74.312,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 117.7,
          "standard_charge_percentage": 55.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 192.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 152.3109,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 155.1928,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 124.12,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 83.674,
          "standard_charge_percentage": 39.1,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 70.192,
          "standard_charge_percentage": 32.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.456,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.904,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 169.0814,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 166.5562,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 168.7604,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 168.7604,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 166.5562,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 146.5472,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 148.4946,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ALBUMIN HUMAN 5 % IV SOLN",
  "drug_information": {
    "unit": 250.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "68516521804",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 53.07,
      "maximum": 192.6,
      "gross_charge": 214.0,
      "discounted_cash": 117.7,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 145.092,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 170.4082,
          "standard_charge_percentage": 79.63,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 128.4,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 127.368,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 63.696,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 125.2114,
          "standard_charge_percentage": 58.51,
          "median_amount": 125.21,
          "10th_percentile": 99.18,
          "90th_percentile": 125.21,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 125.2114,
          "standard_charge_percentage": 58.51,
          "median_amount": 125.21,
          "10th_percentile": 99.18,
          "90th_percentile": 125.21,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 145.52,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 142.6096,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 59.92,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 148.516,
          "standard_charge_percentage": 69.4,
          "median_amount": 147.4,
          "10th_percentile": 147.4,
          "90th_percentile": 147.4,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 180.83,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 146.4732,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 117.7,
          "standard_charge_percentage": 55.0,
          "median_amount": 201.16,
          "10th_percentile": 201.16,
          "90th_percentile": 201.16,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 63.684,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 108.07,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 119.84,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 108.07,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 74.312,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 192.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 152.3109,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 155.1928,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 58.388,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 124.12,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 71.658,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 58.388,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 83.674,
          "standard_charge_percentage": 39.1,
          "median_amount": 70.83,
          "10th_percentile": 70.83,
          "90th_percentile": 70.83,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 70.192,
          "standard_charge_percentage": 32.8,
          "median_amount": 70.83,
          "10th_percentile": 70.83,
          "90th_percentile": 70.83,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.456,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.904,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 169.0814,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 166.5562,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 168.7604,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 166.5562,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 168.7604,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 146.5472,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 148.4946,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ALBUMIN HUMAN 5 % IV SOLN 250 ML BOTTLE (BULK CHARGE)",
  "drug_information": {
    "unit": 250.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "68516521401",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 53.07,
      "maximum": 192.6,
      "gross_charge": 214.0,
      "discounted_cash": 117.7,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 145.092,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 170.4082,
          "standard_charge_percentage": 79.63,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 128.4,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 127.368,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 63.696,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 125.2114,
          "standard_charge_percentage": 58.51,
          "median_amount": 125.21,
          "10th_percentile": 99.18,
          "90th_percentile": 125.21,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 125.2114,
          "standard_charge_percentage": 58.51,
          "median_amount": 125.21,
          "10th_percentile": 99.18,
          "90th_percentile": 125.21,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 142.6096,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 145.52,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 59.92,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 148.516,
          "standard_charge_percentage": 69.4,
          "median_amount": 147.4,
          "10th_percentile": 147.4,
          "90th_percentile": 147.4,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 180.83,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 146.4732,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 117.7,
          "standard_charge_percentage": 55.0,
          "median_amount": 201.16,
          "10th_percentile": 201.16,
          "90th_percentile": 201.16,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 63.684,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 108.07,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 119.84,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 108.07,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 74.312,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 192.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 155.1928,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 152.3109,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 58.388,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 124.12,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bernardino - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sansum Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Santa Barbara Select IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "SCAN",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 71.658,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Seaview IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Seoul Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Sharp Rees-Stealy - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Joseph Heritage - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Mary IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St Vincent IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "St. Jude",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TakeCare HMO",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Teachers Health Trust",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Hospital - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Torrance Memorial Medicare",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 58.388,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Tri Valley - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "TriWest Healthcare Alliance",
          "plan_name": "Other Government",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 70.192,
          "standard_charge_percentage": 32.8,
          "median_amount": 70.83,
          "10th_percentile": 70.83,
          "90th_percentile": 70.83,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Care - PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 83.674,
          "standard_charge_percentage": 39.1,
          "median_amount": 70.83,
          "10th_percentile": 70.83,
          "90th_percentile": 70.83,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 86.456,
          "standard_charge_percentage": 40.4,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UC Ship",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 71.904,
          "standard_charge_percentage": 33.6,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCI University - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UCLA Health Medicare Advantage Plan",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC HMO",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 169.0814,
          "standard_charge_percentage": 79.01,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 166.5562,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Imdemity",
          "plan_name": "Indemity",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 168.7604,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Mediare Advantage",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 166.5562,
          "standard_charge_percentage": 77.83,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 168.7604,
          "standard_charge_percentage": 78.86,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 146.5472,
          "standard_charge_percentage": 68.48,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "UHC Select/SelectPlus",
          "plan_name": "Select-Select Plus",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 148.4946,
          "standard_charge_percentage": 69.39,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "United Family Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Upland Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Valley Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Western Neurological Network - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        }
      ],
      "additional_generic_notes": "0 remits to support allowed amounts"
    }
  ]
},
{
  "description": "ALBUMIN HUMAN 5 % IV SOLN FOR REPLACEMENT FLUIDS",
  "drug_information": {
    "unit": 250.0,
    "type": "UN"
  },
  "code_information": [
    {
      "code": "68516521401_2",
      "type": "NDC"
    }
  ],
  "standard_charges": [
    {
      "minimum": 53.07,
      "maximum": 192.6,
      "gross_charge": 214.0,
      "discounted_cash": 117.7,
      "setting": "outpatient",
      "payers_information": [
        {
          "payer_name": "Access Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 145.092,
          "standard_charge_percentage": 67.8,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Aetna Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Affiliate Health Fund",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Affiliated Health Fund - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "AKM Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alamitos IPA LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Alliance Physicians of the High Desert Inc LOA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Blue Cross",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 170.4082,
          "standard_charge_percentage": 79.63,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Anthem Vivity, Anthem HMO",
          "plan_name": "HMO-NonCity of LA",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Anthem Vivity-Anthem HMO",
          "plan_name": "All Products-HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Apple Care Medical Group St. Francis - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Axminister Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "EPN",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 128.4,
          "standard_charge_percentage": 60.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Blue Shield",
          "plan_name": "Medicare Advantage",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Brookshire IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "California Foundation for Medical Care",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cedars Sinai - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "CenCal Transplant Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Centinela Valley IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Centivo",
          "plan_name": "PPO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 127.368,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Central Health Plan",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 63.696,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Children Hospital of Orange County",
          "plan_name": "Medicaid HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "PPO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 125.2114,
          "standard_charge_percentage": 58.51,
          "median_amount": 125.21,
          "10th_percentile": 99.18,
          "90th_percentile": 125.21,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Cigna",
          "plan_name": "HMO",
          "additional_payer_notes": "Svc. May be packaged/bundled into a separate rate or paid at a % of charge if it exceeds the contractual threshold",
          "standard_charge_dollar": 125.2114,
          "standard_charge_percentage": 58.51,
          "median_amount": 125.21,
          "10th_percentile": 99.18,
          "90th_percentile": 125.21,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "County of Ventura",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Dignity Health Medical Network Central California",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Facey Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Care Specialists - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Choice Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Family Health Alliance - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 142.6096,
          "standard_charge_percentage": 66.64,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "First Health",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 145.52,
          "standard_charge_percentage": 68.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to stoploss provisions",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "standard_charge_algorithm": "Can be subject to stoploss provisions",
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "GemCare PPO",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Gold Coast Health Plan",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 59.92,
          "standard_charge_percentage": 28.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Care LA MediCal - RMG",
          "plan_name": "Medicaid Advantage",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 74.9,
          "standard_charge_percentage": 35.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 148.516,
          "standard_charge_percentage": 69.4,
          "median_amount": 147.4,
          "10th_percentile": 147.4,
          "90th_percentile": 147.4,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Net Non B&G",
          "plan_name": "HMO",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 180.83,
          "standard_charge_percentage": 84.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Health Plan of Nevada Commercial",
          "plan_name": "All Products",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 146.4732,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Health Plan of Nevada Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthCare Partners HMO",
          "plan_name": "HMO-Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 117.7,
          "standard_charge_percentage": 55.0,
          "median_amount": 201.16,
          "10th_percentile": 201.16,
          "90th_percentile": 201.16,
          "count": "1 through 10",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "Workers Compensation",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 63.684,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "HealthSmart",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 181.9,
          "standard_charge_percentage": 85.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "HEREIU Tertiary",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 108.07,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "Medicare",
          "additional_payer_notes": "Can be subject to lesser of provisions",
          "standard_charge_dollar": 108.07,
          "standard_charge_percentage": 50.5,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kaiser",
          "plan_name": "All Products",
          "additional_payer_notes": "Can be subject to lesser of provisions , Percent rate is limited by maximum value, but this maximum can be exceeded by other provisions",
          "standard_charge_dollar": 119.84,
          "standard_charge_percentage": 56.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Kern Family",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Korean American Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "LA Care Covered CA",
          "plan_name": "HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 74.312,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA Care DSNP",
          "plan_name": "Medicare HMO",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "LA care Medi-Cal HMO",
          "plan_name": "Medi-Cal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Lakewood IPA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Memorial Health Care - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "MemorialCare Medical Foundation - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Mercy Healthcare Bakersfield_RRUCLA - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Molina Healthcare HMO",
          "plan_name": "MediCal HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 85.6,
          "standard_charge_percentage": 40.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.08,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Monarch",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Monarch Healthcare - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Multiplan",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 192.6,
          "standard_charge_percentage": 90.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 155.1928,
          "standard_charge_percentage": 72.52,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Optum",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 152.3109,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Physicians Choice Medical Group San Luis Obispo - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Physicians Choice Medical Group Santa Maria - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "PIH Health Physicians - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pinnacle Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Pomona Valley  - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Premier Physician - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health - Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "In these circumstances, the service may be packaged/bundled into a separate rate or priced through a separate carrier where the rate was not available.",
          "standard_charge_algorithm": "Bundled into Service Package",
          "count": "0",
          "methodology": "other"
        },
        {
          "payer_name": "Prime Health- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 171.2,
          "standard_charge_percentage": 80.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Prime Health- Workers Comp",
          "plan_name": "Workers Comp",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 139.1,
          "standard_charge_percentage": 65.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Commercial",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Primecare Transplant",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Private Healthcare System PHC- PPO",
          "plan_name": "PPO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 160.5,
          "standard_charge_percentage": 75.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Providence Healthcare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 58.388,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Prudent Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community General Services",
          "plan_name": "HMO",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 124.12,
          "standard_charge_percentage": 58.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Redlands Community Medicare",
          "plan_name": "Medicare",
          "additional_payer_notes": "Line item charges and subsequent payments can be subject to service bundling. For example, items with a negotiated rate of 0 or blank.",
          "standard_charge_dollar": 53.07,
          "count": "0",
          "methodology": "fee schedule"
        },
        {
          "payer_name": "Redlands Yucaipa Medical Group - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Riverside Medical Clinic - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "Saint Johns - RMG",
          "plan_name": "All Products",
          "additional_payer_notes": "No payer specific notes",
          "standard_charge_dollar": 149.8,
          "standard_charge_percentage": 70.0,
          "count": "0",
          "methodology": "percent of total billed charges"
        },
        {
          "payer_name": "San Bern