{"aaData": [["TL-INPT (INCLUSIVE)", "TORTIOUSLY LIABLE\n", "INPATIENT BEDSECTION STAY\n", "", "001\n", "", ""], ["IA-RX FILL", "INTERAGENCY\n", "PRESCRIPTION FILL\n", "", "250\n", "", ""], ["IA-OPT DENTAL", "INTERAGENCY\n", "OUTPATIENT VISIT DATE\n", "", "512\n", "", ""], ["RX COST", "VA COST\n", "PRESCRIPTION FILL\n", "", "250\n", "PRESCRIPTION\n", ""], ["PI COST", "VA COST\n", "PROSTHETICS ITEM\n", "", "274\n", "OUTPATIENT VISIT\n", ""], ["RC-INPT R&B 402", "RC INPATIENT FACILITY\n", "INPATIENT DRG\n", "INSTITUTIONAL\n", "101\n", "GENERAL MEDICAL CARE\n", "RC 402 - TOGUS, ME\n"], ["RC-INPT ANC 402", "RC INPATIENT FACILITY\n", "INPATIENT DRG\n", "INSTITUTIONAL\n", "240\n", "GENERAL MEDICAL CARE\n", "RC 402 - TOGUS, ME\n"], ["RC-INPT R&B ICU 402", "RC INPATIENT FACILITY\n", "INPATIENT DRG\n", "INSTITUTIONAL\n", "200\n", "ICU\n", "RC 402 - TOGUS, ME\n"], ["RC-INPT ANC ICU 402", "RC INPATIENT FACILITY\n", "INPATIENT DRG\n", "INSTITUTIONAL\n", "240\n", "ICU\n", "RC 402 - TOGUS, ME\n"], ["RC-SNF INC 402", "RC FACILITY PER DIEM\n", "INPATIENT BEDSECTION STAY\n", "INSTITUTIONAL\n", "101\n", "SKILLED NURSING/SUB-ACUTE CARE\n", "RC 402 - TOGUS, ME\n"], ["RC-INPT FAC PR 402", "RC FACILITY PR\n", "PROCEDURE\n", "INSTITUTIONAL\n", "240\n", "GENERAL MEDICAL CARE\n", "RC 402 - TOGUS, ME\n"], ["TL-INPT (NPF)", "TORTIOUSLY LIABLE\n", "INPATIENT BEDSECTION STAY\n", "", "", "", ""], ["RC-INPT FAC HR 402", "RC FACILITY HR\n", "PROCEDURE\n", "INSTITUTIONAL\n", "240\n", "GENERAL MEDICAL CARE\n", "RC 402 - TOGUS, ME\n"], ["RC-INPT FAC ML 402", "RC FACILITY ML\n", "PROCEDURE\n", "INSTITUTIONAL\n", "240\n", "GENERAL MEDICAL CARE\n", "RC 402 - TOGUS, ME\n"], ["RC-SNF FAC PR 402", "RC FACILITY PR\n", "PROCEDURE\n", "INSTITUTIONAL\n", "240\n", "SKILLED NURSING/SUB-ACUTE CARE\n", "RC 402 - TOGUS, ME\n"], ["RC-SNF FAC HR 402", "RC FACILITY HR\n", "PROCEDURE\n", "INSTITUTIONAL\n", "240\n", "SKILLED NURSING/SUB-ACUTE CARE\n", "RC 402 - TOGUS, ME\n"], ["RC-SNF FAC ML 402", "RC FACILITY ML\n", "PROCEDURE\n", "INSTITUTIONAL\n", "240\n", "SKILLED NURSING/SUB-ACUTE CARE\n", "RC 402 - TOGUS, ME\n"], ["RC-PHYSICIAN INPT PR 402", "RC PHYSICIAN PR\n", "PROCEDURE\n", "PROFESSIONAL\n", "960\n", "GENERAL MEDICAL CARE\n", "RC 402 - TOGUS, ME\n"], ["RC-PHYSICIAN INPT MN 402", "RC PHYSICIAN MN\n", "PROCEDURE\n", "PROFESSIONAL\n", "960\n", "GENERAL MEDICAL CARE\n", "RC 402 - TOGUS, ME\n"], ["RC-PHYSICIAN SNF PR 402", "RC PHYSICIAN PR\n", "PROCEDURE\n", "PROFESSIONAL\n", "960\n", "SKILLED NURSING/SUB-ACUTE CARE\n", "RC 402 - TOGUS, ME\n"], ["RC-PHYSICIAN SNF MN 402", "RC PHYSICIAN MN\n", "PROCEDURE\n", "PROFESSIONAL\n", "960\n", "SKILLED NURSING/SUB-ACUTE CARE\n", "RC 402 - TOGUS, ME\n"], ["RC-OPT FAC PR 402", "RC FACILITY PR\n", "PROCEDURE\n", "INSTITUTIONAL\n", "510\n", "OUTPATIENT VISIT\n", "RC 402 - TOGUS, ME\n"], ["TL-INPT (PF)", "TORTIOUSLY LIABLE\n", "INPATIENT BEDSECTION STAY\n", "", "960\n", "", ""], ["RC-OPT FAC HR 402", "RC FACILITY HR\n", "PROCEDURE\n", "INSTITUTIONAL\n", "510\n", "OUTPATIENT VISIT\n", "RC 402 - TOGUS, ME\n"], ["RC-OPT FAC ML 402", "RC FACILITY ML\n", "PROCEDURE\n", "INSTITUTIONAL\n", "510\n", "OUTPATIENT VISIT\n", "RC 402 - TOGUS, ME\n"], ["RC-OPT MISC 402", "RC MISCELLANEOUS\n", "UNASSOCIATED\n", "INSTITUTIONAL\n", "912\n", "PARTIAL HOSPITALIZATION\n", "RC 402 - TOGUS, ME\n"], ["RC-PHYSICIAN OPT PR 402", "RC PHYSICIAN PR\n", "PROCEDURE\n", "PROFESSIONAL\n", "510\n", "OUTPATIENT VISIT\n", "RC 402 - TOGUS, ME\n"], ["RC-PHYSICIAN OPT MN 402", "RC PHYSICIAN MN\n", "PROCEDURE\n", "PROFESSIONAL\n", "510\n", "OUTPATIENT VISIT\n", "RC 402 - TOGUS, ME\n"], ["TL-OPT VST PM&RS", "TORTIOUSLY LIABLE\n", "OUTPATIENT VISIT DATE\n", "", "500\n", "", ""], ["TL-OPT VST POLYTRAUMA", "TORTIOUSLY LIABLE\n", "OUTPATIENT VISIT DATE\n", "", "500\n", "", ""], ["IA-OPT VST PM&RS", "INTERAGENCY\n", "OUTPATIENT VISIT DATE\n", "", "500\n", "", ""], ["IA-OPT VST POLYTRAUMA", "INTERAGENCY\n", "OUTPATIENT VISIT DATE\n", "", "500\n", "", ""], ["RC-INPT R&B 508", "RC INPATIENT FACILITY\n", "INPATIENT DRG\n", "INSTITUTIONAL\n", "101\n", "GENERAL MEDICAL CARE\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["TL-OPT VST", "TORTIOUSLY LIABLE\n", "OUTPATIENT VISIT DATE\n", "", "500\n", "", ""], ["RC-INPT ANC 508", "RC INPATIENT FACILITY\n", "INPATIENT DRG\n", "INSTITUTIONAL\n", "240\n", "GENERAL MEDICAL CARE\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["RC-INPT R&B ICU 508", "RC INPATIENT FACILITY\n", "INPATIENT DRG\n", "INSTITUTIONAL\n", "200\n", "ICU\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["RC-INPT ANC ICU 508", "RC INPATIENT FACILITY\n", "INPATIENT DRG\n", "INSTITUTIONAL\n", "240\n", "ICU\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["RC-SNF INC 508", "RC FACILITY PER DIEM\n", "INPATIENT BEDSECTION STAY\n", "INSTITUTIONAL\n", "101\n", "SKILLED NURSING/SUB-ACUTE CARE\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["RC-INPT FAC PR 508", "RC FACILITY PR\n", "PROCEDURE\n", "INSTITUTIONAL\n", "240\n", "GENERAL MEDICAL CARE\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["RC-INPT FAC HR 508", "RC FACILITY HR\n", "PROCEDURE\n", "INSTITUTIONAL\n", "240\n", "GENERAL MEDICAL CARE\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["RC-INPT FAC ML 508", "RC FACILITY ML\n", "PROCEDURE\n", "INSTITUTIONAL\n", "240\n", "GENERAL MEDICAL CARE\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["RC-SNF FAC PR 508", "RC FACILITY PR\n", "PROCEDURE\n", "INSTITUTIONAL\n", "240\n", "SKILLED NURSING/SUB-ACUTE CARE\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["RC-SNF FAC HR 508", "RC FACILITY HR\n", "PROCEDURE\n", "INSTITUTIONAL\n", "240\n", "SKILLED NURSING/SUB-ACUTE CARE\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["RC-SNF FAC ML 508", "RC FACILITY ML\n", "PROCEDURE\n", "INSTITUTIONAL\n", "240\n", "SKILLED NURSING/SUB-ACUTE CARE\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["TL-RX FILL", "TORTIOUSLY LIABLE\n", "PRESCRIPTION FILL\n", "", "250\n", "", ""], ["RC-PHYSICIAN INPT PR 508", "RC PHYSICIAN PR\n", "PROCEDURE\n", "PROFESSIONAL\n", "960\n", "GENERAL MEDICAL CARE\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["RC-PHYSICIAN INPT MN 508", "RC PHYSICIAN MN\n", "PROCEDURE\n", "PROFESSIONAL\n", "960\n", "GENERAL MEDICAL CARE\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["RC-PHYSICIAN SNF PR 508", "RC PHYSICIAN PR\n", "PROCEDURE\n", "PROFESSIONAL\n", "960\n", "SKILLED NURSING/SUB-ACUTE CARE\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["RC-PHYSICIAN SNF MN 508", "RC PHYSICIAN MN\n", "PROCEDURE\n", "PROFESSIONAL\n", "960\n", "SKILLED NURSING/SUB-ACUTE CARE\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["RC-OPT FAC PR 508", "RC FACILITY PR\n", "PROCEDURE\n", "INSTITUTIONAL\n", "510\n", "OUTPATIENT VISIT\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["RC-OPT FAC HR 508", "RC FACILITY HR\n", "PROCEDURE\n", "INSTITUTIONAL\n", "510\n", "OUTPATIENT VISIT\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["RC-OPT FAC ML 508", "RC FACILITY ML\n", "PROCEDURE\n", "INSTITUTIONAL\n", "510\n", "OUTPATIENT VISIT\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["RC-OPT MISC 508", "RC MISCELLANEOUS\n", "UNASSOCIATED\n", "INSTITUTIONAL\n", "912\n", "PARTIAL HOSPITALIZATION\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["RC-PHYSICIAN OPT PR 508", "RC PHYSICIAN PR\n", "PROCEDURE\n", "PROFESSIONAL\n", "510\n", "OUTPATIENT VISIT\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["RC-PHYSICIAN OPT MN 508", "RC PHYSICIAN MN\n", "PROCEDURE\n", "PROFESSIONAL\n", "510\n", "OUTPATIENT VISIT\n", "RC 508 - DECATUR, GA (ATLANTA\n"], ["TL-OPT DENTAL", "TORTIOUSLY LIABLE\n", "OUTPATIENT VISIT DATE\n", "", "512\n", "", ""], ["TL-MT OPT COPAY", "TORTIOUSLY LIABLE MISC\n", "UNASSOCIATED\n", "", "500\n", "", ""], ["IA-INPT", "INTERAGENCY\n", "INPATIENT BEDSECTION STAY\n", "", "001\n", "", ""], ["IA-OPT VST", "INTERAGENCY\n", "OUTPATIENT VISIT DATE\n", "", "500\n", "", ""]]}