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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":"Claire Tamo"},"financial_aid_policy":["49% off of standard gross charges."],"modifier_information":[{"description":"Technical Component; represents the costs of equipment, supplies, and technician personnel for a procedure, excluding the physician's interpretation. 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4X100X35MM","code_information":[{"code":"Sx00-5204-040","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1713","type":"HCPCS"},{"code":"410497","type":"LOCAL"},{"code":"421384","type":"LOCAL"}],"standard_charges":[{"gross_charge":390.06,"discounted_cash":198.93,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 410497 = Hospital System Supply Identifier | 421384 = Lawson ID"}]},{"description":"PIN FIX EXT HALF 5X160X35MM","code_information":[{"code":"Sx00-5204-050","type":"CDM"},{"code":"272","type":"RC"},{"code":"409364","type":"LOCAL"},{"code":"395474","type":"LOCAL"}],"standard_charges":[{"gross_charge":390.06,"discounted_cash":198.93,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 409364 = Hospital System Supply Identifier | 395474 = Lawson ID"}]},{"description":"PIN FIX EXT 5X160X55MM","code_information":[{"code":"Sx00-5204-050","type":"CDM"},{"code":"272","type":"RC"},{"code":"409365","type":"LOCAL"},{"code":"395475","type":"LOCAL"}],"standard_charges":[{"gross_charge":390.06,"discounted_cash":198.93,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 409365 = Hospital System Supply Identifier | 395475 = Lawson ID"}]},{"description":"PIN FIX EXT HALF 5X200X45MM","code_information":[{"code":"Sx00-5204-050","type":"CDM"},{"code":"272","type":"RC"},{"code":"410532","type":"LOCAL"},{"code":"428125","type":"LOCAL"}],"standard_charges":[{"gross_charge":390.06,"discounted_cash":198.93,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 410532 = Hospital System Supply Identifier | 428125 = Lawson ID"}]},{"description":"PIN FIX EXT HALF 5X200X65MM","code_information":[{"code":"Sx00-5204-050","type":"CDM"},{"code":"272","type":"RC"},{"code":"411190","type":"LOCAL"},{"code":"438994","type":"LOCAL"}],"standard_charges":[{"gross_charge":390.06,"discounted_cash":198.93,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 411190 = Hospital System Supply Identifier | 438994 = Lawson ID"}]},{"description":"PIN FIX EXT 6X200X55MM","code_information":[{"code":"Sx00-5204-060","type":"CDM"},{"code":"272","type":"RC"},{"code":"356301","type":"LOCAL"},{"code":"395476","type":"LOCAL"}],"standard_charges":[{"gross_charge":390.06,"discounted_cash":198.93,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 356301 = Hospital System Supply Identifier | 395476 = Lawson ID"}]},{"description":"PIN FIX EXT TRNSFIXNG BLK 6MM","code_information":[{"code":"Sx00-5204-090","type":"CDM"},{"code":"272","type":"RC"},{"code":"409366","type":"LOCAL"},{"code":"395477","type":"LOCAL"}],"standard_charges":[{"gross_charge":390.06,"discounted_cash":198.93,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 409366 = Hospital System Supply Identifier | 395477 = Lawson ID"}]},{"description":"PIN 1/2 BLUNT 5X160X55MM","code_information":[{"code":"Sx00-5205-050","type":"CDM"},{"code":"272","type":"RC"},{"code":"410520","type":"LOCAL"},{"code":"425148","type":"LOCAL"}],"standard_charges":[{"gross_charge":390.06,"discounted_cash":198.93,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 410520 = Hospital System Supply Identifier | 425148 = Lawson ID"}]},{"description":"DRILL MED 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12","code_information":[{"code":"Sx00-5994-030","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"322050","type":"LOCAL"},{"code":"535264","type":"LOCAL"}],"standard_charges":[{"gross_charge":5735.0,"discounted_cash":2924.85,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 322050 = Hospital System Supply Identifier | 535264 = Lawson ID"}]},{"description":"IMP KNEE SURF ARTC CD 3-4 23","code_information":[{"code":"Sx00-5994-030","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"322051","type":"LOCAL"},{"code":"535265","type":"LOCAL"}],"standard_charges":[{"gross_charge":5735.0,"discounted_cash":2924.85,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 322051 = Hospital System Supply Identifier | 535265 = Lawson ID"}]},{"description":"IMP KNEE TIB INS NXGN 3-4 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23","code_information":[{"code":"Sx00-5994-040","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"322055","type":"LOCAL"},{"code":"535269","type":"LOCAL"}],"standard_charges":[{"gross_charge":5735.0,"discounted_cash":2924.85,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 322055 = Hospital System Supply Identifier | 535269 = Lawson ID"}]},{"description":"IMP TIB NXGN SZ5-6 12MM","code_information":[{"code":"Sx00-5994-040","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"198027","type":"LOCAL"},{"code":"443263","type":"LOCAL"}],"standard_charges":[{"gross_charge":5735.0,"discounted_cash":2924.85,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 198027 = Hospital System Supply Identifier | 443263 = Lawson ID"}]},{"description":"IMP KNEE ART SURF NEXGN 5-6 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LONGEVITY","code_information":[{"code":"Sx00-6305-070","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328976","type":"LOCAL"},{"code":"206444","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 328976 = Hospital System Supply Identifier | 206444 = Lawson ID"}]},{"description":"LINER XLNK 36MM 6305-70-36","code_information":[{"code":"Sx00-6305-070","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328998","type":"LOCAL"},{"code":"207590","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 328998 = Hospital System Supply Identifier | 207590 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 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72X40","code_information":[{"code":"Sx00-6305-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304220","type":"LOCAL"},{"code":"523177","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304220 = Hospital System Supply Identifier | 523177 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 72X36","code_information":[{"code":"Sx00-6305-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304219","type":"LOCAL"},{"code":"523176","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304219 = Hospital System Supply Identifier | 523176 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 72X28","code_information":[{"code":"Sx00-6305-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304217","type":"LOCAL"},{"code":"523174","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304217 = Hospital System Supply Identifier | 523174 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 72X32","code_information":[{"code":"Sx00-6305-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304218","type":"LOCAL"},{"code":"523175","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304218 = Hospital System Supply Identifier | 523175 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 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74X22","code_information":[{"code":"Sx00-6305-074","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304221","type":"LOCAL"},{"code":"523178","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304221 = Hospital System Supply Identifier | 523178 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 74X28","code_information":[{"code":"Sx00-6305-074","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304223","type":"LOCAL"},{"code":"523180","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304223 = Hospital System Supply Identifier | 523180 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 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76X36","code_information":[{"code":"Sx00-6305-076","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"326724","type":"LOCAL"},{"code":"408164","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 326724 = Hospital System Supply Identifier | 408164 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 78X22","code_information":[{"code":"Sx00-6305-078","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304231","type":"LOCAL"},{"code":"523188","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304231 = Hospital System Supply Identifier | 523188 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 78X28","code_information":[{"code":"Sx00-6305-078","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304233","type":"LOCAL"},{"code":"523190","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304233 = Hospital System Supply Identifier | 523190 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 78X32","code_information":[{"code":"Sx00-6305-078","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304234","type":"LOCAL"},{"code":"523191","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304234 = Hospital System Supply Identifier | 523191 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 78X36","code_information":[{"code":"Sx00-6305-078","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304235","type":"LOCAL"},{"code":"523192","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304235 = Hospital System Supply Identifier | 523192 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 78X40","code_information":[{"code":"Sx00-6305-078","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304236","type":"LOCAL"},{"code":"523193","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304236 = Hospital System Supply Identifier | 523193 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 80X40","code_information":[{"code":"Sx00-6305-080","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304242","type":"LOCAL"},{"code":"523199","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304242 = Hospital System Supply Identifier | 523199 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 80X36","code_information":[{"code":"Sx00-6305-080","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304241","type":"LOCAL"},{"code":"523198","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304241 = Hospital System Supply Identifier | 523198 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 80X22","code_information":[{"code":"Sx00-6305-080","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304237","type":"LOCAL"},{"code":"523194","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304237 = Hospital System Supply Identifier | 523194 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 80X28","code_information":[{"code":"Sx00-6305-080","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304239","type":"LOCAL"},{"code":"523196","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304239 = Hospital System Supply Identifier | 523196 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 80X32","code_information":[{"code":"Sx00-6305-080","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304240","type":"LOCAL"},{"code":"523197","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304240 = Hospital System Supply Identifier | 523197 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 36X22","code_information":[{"code":"Sx00-6310-036","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304258","type":"LOCAL"},{"code":"523215","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304258 = Hospital System Supply Identifier | 523215 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 38X22","code_information":[{"code":"Sx00-6310-038","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304259","type":"LOCAL"},{"code":"523216","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304259 = Hospital System Supply Identifier | 523216 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 40X22","code_information":[{"code":"Sx00-6310-040","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304260","type":"LOCAL"},{"code":"523217","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304260 = Hospital System Supply Identifier | 523217 = Lawson ID"}]},{"description":"LINER 10 TRILOGY 6310-42-22","code_information":[{"code":"Sx00-6310-042","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328932","type":"LOCAL"},{"code":"204640","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 328932 = Hospital System Supply Identifier | 204640 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 42X26","code_information":[{"code":"Sx00-6310-042","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304261","type":"LOCAL"},{"code":"523218","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304261 = Hospital System Supply Identifier | 523218 = Lawson ID"}]},{"description":"LINER 10 TRILOGY 6310-44-22","code_information":[{"code":"Sx00-6310-044","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328931","type":"LOCAL"},{"code":"204639","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 328931 = Hospital System Supply Identifier | 204639 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 26X44MM","code_information":[{"code":"Sx00-6310-044","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"326725","type":"LOCAL"},{"code":"408165","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 326725 = Hospital System Supply Identifier | 408165 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 28X44MM","code_information":[{"code":"Sx00-6310-044","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"196298","type":"LOCAL"},{"code":"408166","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 196298 = Hospital System Supply Identifier | 408166 = Lawson ID"}]},{"description":"LINER 10 TRILOGY 6310-46-22","code_information":[{"code":"Sx00-6310-046","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328999","type":"LOCAL"},{"code":"208601","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 328999 = Hospital System Supply Identifier | 208601 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 26X46MM","code_information":[{"code":"Sx00-6310-046","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"326726","type":"LOCAL"},{"code":"408167","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 326726 = Hospital System Supply Identifier | 408167 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 28X46MM","code_information":[{"code":"Sx00-6310-046","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"196299","type":"LOCAL"},{"code":"408168","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 196299 = Hospital System Supply Identifier | 408168 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 48X22","code_information":[{"code":"Sx00-6310-048","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304262","type":"LOCAL"},{"code":"523219","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304262 = Hospital System Supply Identifier | 523219 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 32X48MM","code_information":[{"code":"Sx00-6310-048","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"196300","type":"LOCAL"},{"code":"408170","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 196300 = Hospital System Supply Identifier | 408170 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 26X48MM","code_information":[{"code":"Sx00-6310-048","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"326727","type":"LOCAL"},{"code":"408169","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 326727 = Hospital System Supply Identifier | 408169 = Lawson ID"}]},{"description":"LINER 10 TRILOGY 6310-48-28","code_information":[{"code":"Sx00-6310-048","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"167751","type":"LOCAL"},{"code":"203488","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 167751 = Hospital System Supply Identifier | 203488 = Lawson ID"}]},{"description":"LINER 10 TRILOGY 6310-50-28","code_information":[{"code":"Sx00-6310-050","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"167756","type":"LOCAL"},{"code":"203496","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 167756 = Hospital System Supply Identifier | 203496 = Lawson ID"}]},{"description":"LINER ACETAB 32M 10 LONGEVITY","code_information":[{"code":"Sx00-6310-050","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"168180","type":"LOCAL"},{"code":"206426","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 168180 = Hospital System Supply Identifier | 206426 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 26X50MM","code_information":[{"code":"Sx00-6310-050","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"326728","type":"LOCAL"},{"code":"408171","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 326728 = Hospital System Supply Identifier | 408171 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 50-54X22","code_information":[{"code":"Sx00-6310-050","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304263","type":"LOCAL"},{"code":"523220","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304263 = Hospital System Supply Identifier | 523220 = Lawson ID"}]},{"description":"LINER 10 TRILOGY 6310-56-28","code_information":[{"code":"Sx00-6310-056","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"167755","type":"LOCAL"},{"code":"203495","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 167755 = Hospital System Supply Identifier | 203495 = Lawson ID"}]},{"description":"LINER ACETAB 32M 10 LONGEVITY","code_information":[{"code":"Sx00-6310-056","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328960","type":"LOCAL"},{"code":"206427","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 328960 = Hospital System Supply Identifier | 206427 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 26X56MM","code_information":[{"code":"Sx00-6310-056","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"326729","type":"LOCAL"},{"code":"408172","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 326729 = Hospital System Supply Identifier | 408172 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 56X22","code_information":[{"code":"Sx00-6310-056","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304264","type":"LOCAL"},{"code":"523221","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304264 = Hospital System Supply Identifier | 523221 = Lawson ID"}]},{"description":"LINER 10 TRILOGY 6310-58-28","code_information":[{"code":"Sx00-6310-058","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"167838","type":"LOCAL"},{"code":"203909","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 167838 = Hospital System Supply Identifier | 203909 = Lawson ID"}]},{"description":"LINER ACETAB 32M 10 LONGEVITY","code_information":[{"code":"Sx00-6310-058","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328961","type":"LOCAL"},{"code":"206428","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 328961 = Hospital System Supply Identifier | 206428 = Lawson ID"}]},{"description":"IMP HIP ACET LNR LGVTY 36MM","code_information":[{"code":"Sx00-6310-058","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"149141","type":"LOCAL"},{"code":"236444","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 149141 = Hospital System Supply Identifier | 236444 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 26X58MM","code_information":[{"code":"Sx00-6310-058","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"326730","type":"LOCAL"},{"code":"408173","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 326730 = Hospital System Supply Identifier | 408173 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 58X22","code_information":[{"code":"Sx00-6310-058","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304265","type":"LOCAL"},{"code":"523222","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304265 = Hospital System Supply Identifier | 523222 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 60X26","code_information":[{"code":"Sx00-6310-060","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304267","type":"LOCAL"},{"code":"523224","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304267 = Hospital System Supply Identifier | 523224 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 60X22","code_information":[{"code":"Sx00-6310-060","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304266","type":"LOCAL"},{"code":"523223","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304266 = Hospital System Supply Identifier | 523223 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 60X36","code_information":[{"code":"Sx00-6310-060","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"159043","type":"LOCAL"},{"code":"325078","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 159043 = Hospital System Supply Identifier | 325078 = Lawson ID"}]},{"description":"LINER ACETAB 32M 10 LONGEVITY","code_information":[{"code":"Sx00-6310-060","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328962","type":"LOCAL"},{"code":"206429","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 328962 = Hospital System Supply Identifier | 206429 = Lawson ID"}]},{"description":"LINER 10 TRILOGY 6310-60-28","code_information":[{"code":"Sx00-6310-060","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"167754","type":"LOCAL"},{"code":"203494","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 167754 = Hospital System Supply Identifier | 203494 = Lawson ID"}]},{"description":"LINER 10 TRILOGY 6310-62-28","code_information":[{"code":"Sx00-6310-062","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"167753","type":"LOCAL"},{"code":"203493","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 167753 = Hospital System Supply Identifier | 203493 = Lawson ID"}]},{"description":"LINER ACETAB 32M 10 LONGEVITY","code_information":[{"code":"Sx00-6310-062","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"168181","type":"LOCAL"},{"code":"206430","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 168181 = Hospital System Supply Identifier | 206430 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 62X22","code_information":[{"code":"Sx00-6310-062","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304268","type":"LOCAL"},{"code":"523225","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304268 = Hospital System Supply Identifier | 523225 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 62X26","code_information":[{"code":"Sx00-6310-062","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304269","type":"LOCAL"},{"code":"523226","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304269 = Hospital System Supply Identifier | 523226 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 62X36","code_information":[{"code":"Sx00-6310-062","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304270","type":"LOCAL"},{"code":"523227","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304270 = Hospital System Supply Identifier | 523227 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 64X26","code_information":[{"code":"Sx00-6310-064","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304272","type":"LOCAL"},{"code":"523229","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304272 = Hospital System Supply Identifier | 523229 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 64X22","code_information":[{"code":"Sx00-6310-064","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304271","type":"LOCAL"},{"code":"523228","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304271 = Hospital System Supply Identifier | 523228 = Lawson ID"}]},{"description":"LINER ACETAB 32M 10 LONGEVITY","code_information":[{"code":"Sx00-6310-064","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328963","type":"LOCAL"},{"code":"206431","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 328963 = Hospital System Supply Identifier | 206431 = Lawson ID"}]},{"description":"LINER 10 TRILOGY 6310-64-28","code_information":[{"code":"Sx00-6310-064","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"167752","type":"LOCAL"},{"code":"203489","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 167752 = Hospital System Supply Identifier | 203489 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 64X36","code_information":[{"code":"Sx00-6310-064","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"324846","type":"LOCAL"},{"code":"324310","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 324846 = Hospital System Supply Identifier | 324310 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 66X22","code_information":[{"code":"Sx00-6310-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304273","type":"LOCAL"},{"code":"523230","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304273 = Hospital System Supply Identifier | 523230 = Lawson ID"}]},{"description":"LINER 10 TRILOGY 6310-66-28","code_information":[{"code":"Sx00-6310-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328924","type":"LOCAL"},{"code":"203490","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 328924 = Hospital System Supply Identifier | 203490 = Lawson ID"}]},{"description":"LINER ACETAB 32M 10 LONGEVITY","code_information":[{"code":"Sx00-6310-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328964","type":"LOCAL"},{"code":"206432","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 328964 = Hospital System Supply Identifier | 206432 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 66X36","code_information":[{"code":"Sx00-6310-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"324847","type":"LOCAL"},{"code":"324311","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 324847 = Hospital System Supply Identifier | 324311 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 66X26","code_information":[{"code":"Sx00-6310-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304274","type":"LOCAL"},{"code":"523231","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304274 = Hospital System Supply Identifier | 523231 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 68X26","code_information":[{"code":"Sx00-6310-068","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304276","type":"LOCAL"},{"code":"523233","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304276 = Hospital System Supply Identifier | 523233 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 68X22","code_information":[{"code":"Sx00-6310-068","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304275","type":"LOCAL"},{"code":"523232","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304275 = Hospital System Supply Identifier | 523232 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 68X36","code_information":[{"code":"Sx00-6310-068","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"326731","type":"LOCAL"},{"code":"408174","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 326731 = Hospital System Supply Identifier | 408174 = Lawson ID"}]},{"description":"LINER ACETAB 32M 10 LONGEVITY","code_information":[{"code":"Sx00-6310-068","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328965","type":"LOCAL"},{"code":"206433","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 328965 = Hospital System Supply Identifier | 206433 = Lawson ID"}]},{"description":"LINER 10 TRILOGY 6310-68-28","code_information":[{"code":"Sx00-6310-068","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328925","type":"LOCAL"},{"code":"203491","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 328925 = Hospital System Supply Identifier | 203491 = Lawson ID"}]},{"description":"LINER 10 TRILOGY 6310-70-28","code_information":[{"code":"Sx00-6310-070","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328926","type":"LOCAL"},{"code":"203492","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 328926 = Hospital System Supply Identifier | 203492 = Lawson ID"}]},{"description":"LINER ACETAB 32M 10 LONGEVITY","code_information":[{"code":"Sx00-6310-070","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328966","type":"LOCAL"},{"code":"206434","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 328966 = Hospital System Supply Identifier | 206434 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 70X36","code_information":[{"code":"Sx00-6310-070","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"326732","type":"LOCAL"},{"code":"408175","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 326732 = Hospital System Supply Identifier | 408175 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 70X22","code_information":[{"code":"Sx00-6310-070","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304277","type":"LOCAL"},{"code":"523234","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304277 = Hospital System Supply Identifier | 523234 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 70X26","code_information":[{"code":"Sx00-6310-070","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304278","type":"LOCAL"},{"code":"523235","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304278 = Hospital System Supply Identifier | 523235 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 72X36","code_information":[{"code":"Sx00-6310-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304283","type":"LOCAL"},{"code":"523240","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304283 = Hospital System Supply Identifier | 523240 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 72X32","code_information":[{"code":"Sx00-6310-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304282","type":"LOCAL"},{"code":"523239","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304282 = Hospital System Supply Identifier | 523239 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 72X28","code_information":[{"code":"Sx00-6310-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304281","type":"LOCAL"},{"code":"523238","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304281 = Hospital System Supply Identifier | 523238 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 72X26","code_information":[{"code":"Sx00-6310-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304280","type":"LOCAL"},{"code":"523237","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304280 = Hospital System Supply Identifier | 523237 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 72X22","code_information":[{"code":"Sx00-6310-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304279","type":"LOCAL"},{"code":"523236","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304279 = Hospital System Supply Identifier | 523236 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 74X22","code_information":[{"code":"Sx00-6310-074","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304284","type":"LOCAL"},{"code":"523241","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304284 = Hospital System Supply Identifier | 523241 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 74X26","code_information":[{"code":"Sx00-6310-074","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304285","type":"LOCAL"},{"code":"523242","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304285 = Hospital System Supply Identifier | 523242 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 74X28","code_information":[{"code":"Sx00-6310-074","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304286","type":"LOCAL"},{"code":"523243","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304286 = Hospital System Supply Identifier | 523243 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 74X32","code_information":[{"code":"Sx00-6310-074","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304287","type":"LOCAL"},{"code":"523244","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304287 = Hospital System Supply Identifier | 523244 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 74X36","code_information":[{"code":"Sx00-6310-074","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304288","type":"LOCAL"},{"code":"523245","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304288 = Hospital System Supply Identifier | 523245 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 76X36","code_information":[{"code":"Sx00-6310-076","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304293","type":"LOCAL"},{"code":"523250","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304293 = Hospital System Supply Identifier | 523250 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 76X32","code_information":[{"code":"Sx00-6310-076","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304292","type":"LOCAL"},{"code":"523249","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304292 = Hospital System Supply Identifier | 523249 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 76X22","code_information":[{"code":"Sx00-6310-076","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304289","type":"LOCAL"},{"code":"523246","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304289 = Hospital System Supply Identifier | 523246 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 76X26","code_information":[{"code":"Sx00-6310-076","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304290","type":"LOCAL"},{"code":"523247","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304290 = Hospital System Supply Identifier | 523247 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 76X28","code_information":[{"code":"Sx00-6310-076","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304291","type":"LOCAL"},{"code":"523248","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304291 = Hospital System Supply Identifier | 523248 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 78X22","code_information":[{"code":"Sx00-6310-078","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304294","type":"LOCAL"},{"code":"523251","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304294 = Hospital System Supply Identifier | 523251 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 78X26","code_information":[{"code":"Sx00-6310-078","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304295","type":"LOCAL"},{"code":"523252","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304295 = Hospital System Supply Identifier | 523252 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 78X28","code_information":[{"code":"Sx00-6310-078","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304296","type":"LOCAL"},{"code":"523253","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304296 = Hospital System Supply Identifier | 523253 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 78X32","code_information":[{"code":"Sx00-6310-078","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304297","type":"LOCAL"},{"code":"523254","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304297 = Hospital System Supply Identifier | 523254 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 78X36","code_information":[{"code":"Sx00-6310-078","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304298","type":"LOCAL"},{"code":"523255","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304298 = Hospital System Supply Identifier | 523255 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 80X36","code_information":[{"code":"Sx00-6310-080","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"325147","type":"LOCAL"},{"code":"340104","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 325147 = Hospital System Supply Identifier | 340104 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 80X22","code_information":[{"code":"Sx00-6310-080","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304299","type":"LOCAL"},{"code":"523256","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304299 = Hospital System Supply Identifier | 523256 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 80X26","code_information":[{"code":"Sx00-6310-080","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304300","type":"LOCAL"},{"code":"523257","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304300 = Hospital System Supply Identifier | 523257 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 80X28","code_information":[{"code":"Sx00-6310-080","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304301","type":"LOCAL"},{"code":"523258","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304301 = Hospital System Supply Identifier | 523258 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 80X32","code_information":[{"code":"Sx00-6310-080","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304302","type":"LOCAL"},{"code":"523259","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304302 = Hospital System Supply Identifier | 523259 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 36X22","code_information":[{"code":"Sx00-6320-036","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304303","type":"LOCAL"},{"code":"523260","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304303 = Hospital System Supply Identifier | 523260 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 38X22","code_information":[{"code":"Sx00-6320-038","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304304","type":"LOCAL"},{"code":"523261","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304304 = Hospital System Supply Identifier | 523261 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 40X22","code_information":[{"code":"Sx00-6320-040","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304305","type":"LOCAL"},{"code":"523262","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304305 = Hospital System Supply Identifier | 523262 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 42X26","code_information":[{"code":"Sx00-6320-042","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304307","type":"LOCAL"},{"code":"523264","type":"LOCAL"}],"standard_charges":[{"gross_charge":4172.0,"discounted_cash":2127.72,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304307 = Hospital System Supply Identifier | 523264 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 42X22","code_information":[{"code":"Sx00-6320-042","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304306","type":"LOCAL"},{"code":"523263","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304306 = Hospital System Supply Identifier | 523263 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 44X22","code_information":[{"code":"Sx00-6320-044","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304308","type":"LOCAL"},{"code":"523265","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304308 = Hospital System Supply Identifier | 523265 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 44X26","code_information":[{"code":"Sx00-6320-044","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304309","type":"LOCAL"},{"code":"523266","type":"LOCAL"}],"standard_charges":[{"gross_charge":4172.0,"discounted_cash":2127.72,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304309 = Hospital System Supply Identifier | 523266 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 44X28","code_information":[{"code":"Sx00-6320-044","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304310","type":"LOCAL"},{"code":"523267","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304310 = Hospital System Supply Identifier | 523267 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 46X22","code_information":[{"code":"Sx00-6320-046","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304311","type":"LOCAL"},{"code":"523268","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304311 = Hospital System Supply Identifier | 523268 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 46X26","code_information":[{"code":"Sx00-6320-046","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304312","type":"LOCAL"},{"code":"523269","type":"LOCAL"}],"standard_charges":[{"gross_charge":4172.0,"discounted_cash":2127.72,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304312 = Hospital System Supply Identifier | 523269 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 46X28","code_information":[{"code":"Sx00-6320-046","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304313","type":"LOCAL"},{"code":"523270","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304313 = Hospital System Supply Identifier | 523270 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 48X22","code_information":[{"code":"Sx00-6320-048","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304314","type":"LOCAL"},{"code":"523271","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304314 = Hospital System Supply Identifier | 523271 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 48X26","code_information":[{"code":"Sx00-6320-048","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304315","type":"LOCAL"},{"code":"523272","type":"LOCAL"}],"standard_charges":[{"gross_charge":4172.0,"discounted_cash":2127.72,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304315 = Hospital System Supply Identifier | 523272 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 48X28","code_information":[{"code":"Sx00-6320-048","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304316","type":"LOCAL"},{"code":"523273","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304316 = Hospital System Supply Identifier | 523273 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 48X32","code_information":[{"code":"Sx00-6320-048","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304317","type":"LOCAL"},{"code":"523274","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304317 = Hospital System Supply Identifier | 523274 = Lawson ID"}]},{"description":"IMP HIP ACET LNR LGVTY50/52/54","code_information":[{"code":"Sx00-6320-050","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"150025","type":"LOCAL"},{"code":"237682","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 150025 = Hospital System Supply Identifier | 237682 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 50X28","code_information":[{"code":"Sx00-6320-050","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"324848","type":"LOCAL"},{"code":"324312","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 324848 = Hospital System Supply Identifier | 324312 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 50-54X22","code_information":[{"code":"Sx00-6320-050","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304318","type":"LOCAL"},{"code":"523275","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304318 = Hospital System Supply Identifier | 523275 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 50-54X26","code_information":[{"code":"Sx00-6320-050","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304319","type":"LOCAL"},{"code":"523276","type":"LOCAL"}],"standard_charges":[{"gross_charge":4172.0,"discounted_cash":2127.72,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304319 = Hospital System Supply Identifier | 523276 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 56X26","code_information":[{"code":"Sx00-6320-056","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304321","type":"LOCAL"},{"code":"523278","type":"LOCAL"}],"standard_charges":[{"gross_charge":4172.0,"discounted_cash":2127.72,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304321 = Hospital System Supply Identifier | 523278 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 56X28","code_information":[{"code":"Sx00-6320-056","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304322","type":"LOCAL"},{"code":"523279","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304322 = Hospital System Supply Identifier | 523279 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 56X32","code_information":[{"code":"Sx00-6320-056","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"198410","type":"LOCAL"},{"code":"443663","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 198410 = Hospital System Supply Identifier | 443663 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 56X22","code_information":[{"code":"Sx00-6320-056","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304320","type":"LOCAL"},{"code":"523277","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304320 = Hospital System Supply Identifier | 523277 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 58X22","code_information":[{"code":"Sx00-6320-058","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304323","type":"LOCAL"},{"code":"523280","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304323 = Hospital System Supply Identifier | 523280 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 58X26","code_information":[{"code":"Sx00-6320-058","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304324","type":"LOCAL"},{"code":"523281","type":"LOCAL"}],"standard_charges":[{"gross_charge":4172.0,"discounted_cash":2127.72,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304324 = Hospital System Supply Identifier | 523281 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 58X28","code_information":[{"code":"Sx00-6320-058","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304325","type":"LOCAL"},{"code":"523282","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304325 = Hospital System Supply Identifier | 523282 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 58X32","code_information":[{"code":"Sx00-6320-058","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304326","type":"LOCAL"},{"code":"523283","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304326 = Hospital System Supply Identifier | 523283 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 60X28","code_information":[{"code":"Sx00-6320-060","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304329","type":"LOCAL"},{"code":"523286","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 304329 = Hospital System Supply Identifier | 523286 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 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32M","code_information":[{"code":"Sx00-6341-064","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328991","type":"LOCAL"},{"code":"206610","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 328991 = Hospital System Supply Identifier | 206610 = Lawson ID"}]},{"description":"LINER LONGEVITY 7MM OFFSET 32M","code_information":[{"code":"Sx00-6341-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328987","type":"LOCAL"},{"code":"206469","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 328987 = Hospital System Supply Identifier | 206469 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 7MM OFF 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20MM","code_information":[{"code":"Sx00-6624-065","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1713","type":"HCPCS"},{"code":"329401","type":"LOCAL"},{"code":"324325","type":"LOCAL"}],"standard_charges":[{"gross_charge":192.0,"discounted_cash":97.92,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 329401 = Hospital System Supply Identifier | 324325 = Lawson ID"}]},{"description":"SCREW SLF-TP HGPII 6.5X30MM","code_information":[{"code":"Sx00-6624-065","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1713","type":"HCPCS"},{"code":"329896","type":"LOCAL"},{"code":"395504","type":"LOCAL"}],"standard_charges":[{"gross_charge":192.0,"discounted_cash":97.92,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 329896 = Hospital System Supply Identifier | 395504 = Lawson ID"}]},{"description":"SCREW SLF-TP HGP2 6.5X60MM","code_information":[{"code":"Sx00-6624-065","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1713","type":"HCPCS"},{"code":"330243","type":"LOCAL"},{"code":"433897","type":"LOCAL"}],"standard_charges":[{"gross_charge":192.0,"discounted_cash":97.92,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 330243 = Hospital System Supply Identifier | 433897 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL REV 48","code_information":[{"code":"Sx00-7000-048","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"321689","type":"LOCAL"},{"code":"534903","type":"LOCAL"}],"standard_charges":[{"gross_charge":6480.0,"discounted_cash":3304.8,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 321689 = Hospital System Supply Identifier | 534903 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL 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66MM","code_information":[{"code":"Sx00-7053-066","type":"CDM"},{"code":"272","type":"RC"},{"code":"193497","type":"LOCAL"},{"code":"310999","type":"LOCAL"}],"standard_charges":[{"gross_charge":2408.0,"discounted_cash":1228.08,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 193497 = Hospital System Supply Identifier | 310999 = Lawson ID"}]},{"description":"BLADE EXPLANT TRUN 66MM","code_information":[{"code":"Sx00-7053-066","type":"CDM"},{"code":"272","type":"RC"},{"code":"193493","type":"LOCAL"},{"code":"310992","type":"LOCAL"}],"standard_charges":[{"gross_charge":2408.0,"discounted_cash":1228.08,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 193493 = Hospital System Supply Identifier | 310992 = Lawson ID"}]},{"description":"BLADE EXPLANT TRUN 68MM","code_information":[{"code":"Sx00-7053-068","type":"CDM"},{"code":"272","type":"RC"},{"code":"193494","type":"LOCAL"},{"code":"310993","type":"LOCAL"}],"standard_charges":[{"gross_charge":2408.0,"discounted_cash":1228.08,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 193494 = Hospital System Supply Identifier | 310993 = Lawson ID"}]},{"description":"BLADE EXPLANT FULL 68MM","code_information":[{"code":"Sx00-7053-068","type":"CDM"},{"code":"272","type":"RC"},{"code":"193498","type":"LOCAL"},{"code":"311000","type":"LOCAL"}],"standard_charges":[{"gross_charge":2408.0,"discounted_cash":1228.08,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 193498 = Hospital System Supply Identifier | 311000 = Lawson ID"}]},{"description":"BLADE EXPLANT TRUN 70MM","code_information":[{"code":"Sx00-7053-070","type":"CDM"},{"code":"272","type":"RC"},{"code":"195056","type":"LOCAL"},{"code":"361331","type":"LOCAL"}],"standard_charges":[{"gross_charge":2408.0,"discounted_cash":1228.08,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 195056 = Hospital System Supply Identifier | 361331 = Lawson ID"}]},{"description":"BLADE EXPLANT FULL 70MM","code_information":[{"code":"Sx00-7053-070","type":"CDM"},{"code":"272","type":"RC"},{"code":"195058","type":"LOCAL"},{"code":"361333","type":"LOCAL"}],"standard_charges":[{"gross_charge":2408.0,"discounted_cash":1228.08,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 195058 = Hospital System Supply Identifier | 361333 = Lawson ID"}]},{"description":"BLADE EXPLANT TRUN 72MM","code_information":[{"code":"Sx00-7053-072","type":"CDM"},{"code":"272","type":"RC"},{"code":"195057","type":"LOCAL"},{"code":"361332","type":"LOCAL"}],"standard_charges":[{"gross_charge":2408.0,"discounted_cash":1228.08,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 195057 = Hospital System Supply Identifier | 361332 = Lawson ID"}]},{"description":"BLADE EXPLANT FULL 72MM","code_information":[{"code":"Sx00-7053-072","type":"CDM"},{"code":"272","type":"RC"},{"code":"195059","type":"LOCAL"},{"code":"361334","type":"LOCAL"}],"standard_charges":[{"gross_charge":2408.0,"discounted_cash":1228.08,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 195059 = Hospital System Supply Identifier | 361334 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL 28X48MM","code_information":[{"code":"Sx00-7105-048","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"198404","type":"LOCAL"},{"code":"443656","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 198404 = Hospital System Supply Identifier | 443656 = Lawson ID"}]},{"description":"IMP HIP ACET LNR NEUT 0D 28X50","code_information":[{"code":"Sx00-7105-050","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320927","type":"LOCAL"},{"code":"534141","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320927 = Hospital System Supply Identifier | 534141 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL 0D 28X52MM","code_information":[{"code":"Sx00-7105-052","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"198403","type":"LOCAL"},{"code":"443655","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 198403 = Hospital System Supply Identifier | 443655 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL 0D 32X54MM","code_information":[{"code":"Sx00-7105-054","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"202086","type":"LOCAL"},{"code":"452182","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 202086 = Hospital System Supply Identifier | 452182 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 54X28","code_information":[{"code":"Sx00-7105-054","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320928","type":"LOCAL"},{"code":"534142","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320928 = Hospital System Supply Identifier | 534142 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 56X28","code_information":[{"code":"Sx00-7105-056","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320929","type":"LOCAL"},{"code":"534143","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320929 = Hospital System Supply Identifier | 534143 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 56X32","code_information":[{"code":"Sx00-7105-056","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320930","type":"LOCAL"},{"code":"534144","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320930 = Hospital System Supply Identifier | 534144 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 58X28","code_information":[{"code":"Sx00-7105-058","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320931","type":"LOCAL"},{"code":"534145","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320931 = Hospital System Supply Identifier | 534145 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 58X32","code_information":[{"code":"Sx00-7105-058","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320932","type":"LOCAL"},{"code":"534146","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320932 = Hospital System Supply Identifier | 534146 = Lawson ID"}]},{"description":"LINER REV HIP TM NEU LNG 36X58","code_information":[{"code":"Sx00-7105-058","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"195289","type":"LOCAL"},{"code":"372221","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 195289 = Hospital System Supply Identifier | 372221 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 60X36","code_information":[{"code":"Sx00-7105-060","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320934","type":"LOCAL"},{"code":"534148","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320934 = Hospital System Supply Identifier | 534148 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL 0D 32X60MM","code_information":[{"code":"Sx00-7105-060","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"198402","type":"LOCAL"},{"code":"443654","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 198402 = Hospital System Supply Identifier | 443654 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 60X28","code_information":[{"code":"Sx00-7105-060","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320933","type":"LOCAL"},{"code":"534147","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320933 = Hospital System Supply Identifier | 534147 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL 0D 40X62MM","code_information":[{"code":"Sx00-7105-062","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"198400","type":"LOCAL"},{"code":"443652","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 198400 = Hospital System Supply Identifier | 443652 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 62/64X28","code_information":[{"code":"Sx00-7105-062","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320935","type":"LOCAL"},{"code":"534149","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320935 = Hospital System Supply Identifier | 534149 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 62/64X32","code_information":[{"code":"Sx00-7105-062","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320936","type":"LOCAL"},{"code":"534150","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320936 = Hospital System Supply Identifier | 534150 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 62/64X36","code_information":[{"code":"Sx00-7105-062","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320937","type":"LOCAL"},{"code":"534151","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320937 = Hospital System Supply Identifier | 534151 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 66-70X32","code_information":[{"code":"Sx00-7105-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320939","type":"LOCAL"},{"code":"534153","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320939 = Hospital System Supply Identifier | 534153 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 66-70X36","code_information":[{"code":"Sx00-7105-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320940","type":"LOCAL"},{"code":"534154","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320940 = Hospital System Supply Identifier | 534154 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL 0D 40X66-70","code_information":[{"code":"Sx00-7105-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"202085","type":"LOCAL"},{"code":"452181","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 202085 = Hospital System Supply Identifier | 452181 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 66-70X28","code_information":[{"code":"Sx00-7105-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320938","type":"LOCAL"},{"code":"534152","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320938 = Hospital System Supply Identifier | 534152 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 72/74X28","code_information":[{"code":"Sx00-7105-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320941","type":"LOCAL"},{"code":"534155","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320941 = Hospital System Supply Identifier | 534155 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 72/74X32","code_information":[{"code":"Sx00-7105-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320942","type":"LOCAL"},{"code":"534156","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320942 = Hospital System Supply Identifier | 534156 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 72/74X36","code_information":[{"code":"Sx00-7105-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320943","type":"LOCAL"},{"code":"534157","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320943 = Hospital System Supply Identifier | 534157 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 72/74X40","code_information":[{"code":"Sx00-7105-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320944","type":"LOCAL"},{"code":"534158","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320944 = Hospital System Supply Identifier | 534158 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 76-80X36","code_information":[{"code":"Sx00-7105-076","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320947","type":"LOCAL"},{"code":"534161","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320947 = Hospital System Supply Identifier | 534161 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 76-80X28","code_information":[{"code":"Sx00-7105-076","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320945","type":"LOCAL"},{"code":"534159","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320945 = Hospital System Supply Identifier | 534159 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 76-80X32","code_information":[{"code":"Sx00-7105-076","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320946","type":"LOCAL"},{"code":"534160","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320946 = Hospital System Supply Identifier | 534160 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 0D 76-80X40","code_information":[{"code":"Sx00-7105-076","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320948","type":"LOCAL"},{"code":"534162","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320948 = Hospital System Supply Identifier | 534162 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 48X28","code_information":[{"code":"Sx00-7110-048","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320949","type":"LOCAL"},{"code":"534163","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320949 = Hospital System Supply Identifier | 534163 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 50X28","code_information":[{"code":"Sx00-7110-050","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320950","type":"LOCAL"},{"code":"534164","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320950 = Hospital System Supply Identifier | 534164 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 52X28","code_information":[{"code":"Sx00-7110-052","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320951","type":"LOCAL"},{"code":"534165","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320951 = Hospital System Supply Identifier | 534165 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 32X54MM","code_information":[{"code":"Sx00-7110-054","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"202098","type":"LOCAL"},{"code":"452194","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 202098 = Hospital System Supply Identifier | 452194 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 54X28","code_information":[{"code":"Sx00-7110-054","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320952","type":"LOCAL"},{"code":"534166","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320952 = Hospital System Supply Identifier | 534166 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 56X28","code_information":[{"code":"Sx00-7110-056","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320953","type":"LOCAL"},{"code":"534167","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320953 = Hospital System Supply Identifier | 534167 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 56X32","code_information":[{"code":"Sx00-7110-056","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320954","type":"LOCAL"},{"code":"534168","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320954 = Hospital System Supply Identifier | 534168 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 58X28","code_information":[{"code":"Sx00-7110-058","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320955","type":"LOCAL"},{"code":"534169","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320955 = Hospital System Supply Identifier | 534169 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 58X32","code_information":[{"code":"Sx00-7110-058","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320956","type":"LOCAL"},{"code":"534170","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320956 = Hospital System Supply Identifier | 534170 = Lawson ID"}]},{"description":"IMP HIP ACET LNR LGVTY 58X36","code_information":[{"code":"Sx00-7110-058","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"202100","type":"LOCAL"},{"code":"452196","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 202100 = Hospital System Supply Identifier | 452196 = Lawson ID"}]},{"description":"IMP HIP ACET LNR10D 60X36MM","code_information":[{"code":"Sx00-7110-060","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"202101","type":"LOCAL"},{"code":"452197","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 202101 = Hospital System Supply Identifier | 452197 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 60X28","code_information":[{"code":"Sx00-7110-060","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320957","type":"LOCAL"},{"code":"534171","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320957 = Hospital System Supply Identifier | 534171 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 60X32","code_information":[{"code":"Sx00-7110-060","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320958","type":"LOCAL"},{"code":"534172","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320958 = Hospital System Supply Identifier | 534172 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 40X62/64","code_information":[{"code":"Sx00-7110-062","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"202099","type":"LOCAL"},{"code":"452195","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 202099 = Hospital System Supply Identifier | 452195 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 62/64X28","code_information":[{"code":"Sx00-7110-062","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320959","type":"LOCAL"},{"code":"534173","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320959 = Hospital System Supply Identifier | 534173 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 62X32","code_information":[{"code":"Sx00-7110-062","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320960","type":"LOCAL"},{"code":"534174","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320960 = Hospital System Supply Identifier | 534174 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 62X32","code_information":[{"code":"Sx00-7110-062","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320961","type":"LOCAL"},{"code":"534175","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320961 = Hospital System Supply Identifier | 534175 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 66-70X32","code_information":[{"code":"Sx00-7110-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320963","type":"LOCAL"},{"code":"534177","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320963 = Hospital System Supply Identifier | 534177 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 36X62/64","code_information":[{"code":"Sx00-7110-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"202102","type":"LOCAL"},{"code":"452198","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 202102 = Hospital System Supply Identifier | 452198 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 40MM","code_information":[{"code":"Sx00-7110-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"194975","type":"LOCAL"},{"code":"360636","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 194975 = Hospital System Supply Identifier | 360636 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 66-70X28","code_information":[{"code":"Sx00-7110-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320962","type":"LOCAL"},{"code":"534176","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320962 = Hospital System Supply Identifier | 534176 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 72/74X28","code_information":[{"code":"Sx00-7110-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320964","type":"LOCAL"},{"code":"534178","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320964 = Hospital System Supply Identifier | 534178 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 72/74X32","code_information":[{"code":"Sx00-7110-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320965","type":"LOCAL"},{"code":"534179","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320965 = Hospital System Supply Identifier | 534179 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 72/74X36","code_information":[{"code":"Sx00-7110-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320966","type":"LOCAL"},{"code":"534180","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320966 = Hospital System Supply Identifier | 534180 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 10D 72/74X40","code_information":[{"code":"Sx00-7110-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320967","type":"LOCAL"},{"code":"534181","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320967 = Hospital System Supply Identifier | 534181 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 76-80X28","code_information":[{"code":"Sx00-7110-076","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320968","type":"LOCAL"},{"code":"534182","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320968 = Hospital System Supply Identifier | 534182 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 76-80X32","code_information":[{"code":"Sx00-7110-076","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320969","type":"LOCAL"},{"code":"534183","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320969 = Hospital System Supply Identifier | 534183 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 76-80X36","code_information":[{"code":"Sx00-7110-076","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320970","type":"LOCAL"},{"code":"534184","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320970 = Hospital System Supply Identifier | 534184 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 76-80X40","code_information":[{"code":"Sx00-7110-076","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320971","type":"LOCAL"},{"code":"534185","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320971 = Hospital System Supply Identifier | 534185 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL 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54X32MM","code_information":[{"code":"Sx00-7115-054","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"198399","type":"LOCAL"},{"code":"443651","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 198399 = Hospital System Supply Identifier | 443651 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL TM 56X32","code_information":[{"code":"Sx00-7115-056","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320973","type":"LOCAL"},{"code":"534187","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320973 = Hospital System Supply Identifier | 534187 = Lawson ID"}]},{"description":"IMP HIP LNR CNSTRN CEM 36X58MM","code_information":[{"code":"Sx00-7115-058","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"202088","type":"LOCAL"},{"code":"452184","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 202088 = Hospital System Supply Identifier | 452184 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL TM 60X36","code_information":[{"code":"Sx00-7115-060","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320974","type":"LOCAL"},{"code":"534188","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320974 = Hospital System Supply Identifier | 534188 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL TM 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72/74X36","code_information":[{"code":"Sx00-7115-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320976","type":"LOCAL"},{"code":"534190","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320976 = Hospital System Supply Identifier | 534190 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL 76/78/80X36","code_information":[{"code":"Sx00-7115-076","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320977","type":"LOCAL"},{"code":"534191","type":"LOCAL"}],"standard_charges":[{"gross_charge":5920.0,"discounted_cash":3019.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 320977 = Hospital System Supply Identifier | 534191 = Lawson ID"}]},{"description":"IMP ACET CAGE SHRT FLG 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55-66","code_information":[{"code":"Sx00-7123-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"326741","type":"LOCAL"},{"code":"408186","type":"LOCAL"}],"standard_charges":[{"gross_charge":6300.0,"discounted_cash":3213.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 326741 = Hospital System Supply Identifier | 408186 = Lawson ID"}]},{"description":"IMP ACET CAGE TRBC RT 72-74","code_information":[{"code":"Sx00-7123-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"325647","type":"LOCAL"},{"code":"360638","type":"LOCAL"}],"standard_charges":[{"gross_charge":6300.0,"discounted_cash":3213.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 325647 = Hospital System Supply Identifier | 360638 = Lawson ID"}]},{"description":"IMP HIP CAGE SHRT RT 76/78/80","code_information":[{"code":"Sx00-7123-076","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"321696","type":"LOCAL"},{"code":"534910","type":"LOCAL"}],"standard_charges":[{"gross_charge":6300.0,"discounted_cash":3213.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 321696 = Hospital System Supply Identifier | 534910 = Lawson ID"}]},{"description":"IMP HIP CAGE SHRT LT 56/58/60","code_information":[{"code":"Sx00-7124-056","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"321697","type":"LOCAL"},{"code":"534911","type":"LOCAL"}],"standard_charges":[{"gross_charge":6300.0,"discounted_cash":3213.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 321697 = Hospital System Supply Identifier | 534911 = Lawson ID"}]},{"description":"IMP HIP CAGE SHRT LT 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72/74","code_information":[{"code":"Sx00-7124-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"321700","type":"LOCAL"},{"code":"534914","type":"LOCAL"}],"standard_charges":[{"gross_charge":6300.0,"discounted_cash":3213.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 321700 = Hospital System Supply Identifier | 534914 = Lawson ID"}]},{"description":"IMP HIP SHELL TM SHRT CAGE LT","code_information":[{"code":"Sx00-7124-076","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"326914","type":"LOCAL"},{"code":"402766","type":"LOCAL"}],"standard_charges":[{"gross_charge":6300.0,"discounted_cash":3213.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 326914 = Hospital System Supply Identifier | 402766 = Lawson ID"}]},{"description":"IMP HIP CAGE LNG RT 56/58/60","code_information":[{"code":"Sx00-7125-056","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"321701","type":"LOCAL"},{"code":"534915","type":"LOCAL"}],"standard_charges":[{"gross_charge":6300.0,"discounted_cash":3213.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 321701 = Hospital System Supply Identifier | 534915 = Lawson ID"}]},{"description":"IMP HIP CAGE LNG RT 62/64","code_information":[{"code":"Sx00-7125-062","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"321702","type":"LOCAL"},{"code":"534916","type":"LOCAL"}],"standard_charges":[{"gross_charge":6300.0,"discounted_cash":3213.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 321702 = Hospital System Supply Identifier | 534916 = Lawson ID"}]},{"description":"IMP HIP CAGE LNG RT 66/68/70","code_information":[{"code":"Sx00-7125-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"321703","type":"LOCAL"},{"code":"534917","type":"LOCAL"}],"standard_charges":[{"gross_charge":6300.0,"discounted_cash":3213.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 321703 = Hospital System Supply Identifier | 534917 = Lawson ID"}]},{"description":"IMP HIP CAGE LNG RT 72/74","code_information":[{"code":"Sx00-7125-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"321704","type":"LOCAL"},{"code":"534918","type":"LOCAL"}],"standard_charges":[{"gross_charge":6300.0,"discounted_cash":3213.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 321704 = Hospital System Supply Identifier | 534918 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL TM RT 76-80","code_information":[{"code":"Sx00-7125-076","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"325648","type":"LOCAL"},{"code":"360639","type":"LOCAL"}],"standard_charges":[{"gross_charge":6300.0,"discounted_cash":3213.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 325648 = Hospital System Supply Identifier | 360639 = Lawson ID"}]},{"description":"IMP HIP CAGE LNG LT 56/58/60","code_information":[{"code":"Sx00-7126-056","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"321705","type":"LOCAL"},{"code":"534919","type":"LOCAL"}],"standard_charges":[{"gross_charge":6300.0,"discounted_cash":3213.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 321705 = Hospital System Supply Identifier | 534919 = Lawson ID"}]},{"description":"IMP HIP CAGE LNG LT 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72/74","code_information":[{"code":"Sx00-7126-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"321708","type":"LOCAL"},{"code":"534922","type":"LOCAL"}],"standard_charges":[{"gross_charge":6300.0,"discounted_cash":3213.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 321708 = Hospital System Supply Identifier | 534922 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL TM LT 76-80","code_information":[{"code":"Sx00-7126-076","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"325649","type":"LOCAL"},{"code":"360640","type":"LOCAL"}],"standard_charges":[{"gross_charge":6300.0,"discounted_cash":3213.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 325649 = Hospital System Supply Identifier | 360640 = Lawson ID"}]},{"description":"IMP HIP TRL ACET CAGE TRBC 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7859-12","code_information":[{"code":"Sx00-7859-012","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"145637","type":"LOCAL"},{"code":"203794","type":"LOCAL"}],"standard_charges":[{"gross_charge":275.0,"discounted_cash":140.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 145637 = Hospital System Supply Identifier | 203794 = Lawson ID"}]},{"description":"IMP DISTAL CENT 7859-13","code_information":[{"code":"Sx00-7859-013","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"145638","type":"LOCAL"},{"code":"203795","type":"LOCAL"}],"standard_charges":[{"gross_charge":275.0,"discounted_cash":140.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 145638 = Hospital System Supply Identifier | 203795 = Lawson ID"}]},{"description":"IMP DISTAL CENT 7859-14","code_information":[{"code":"Sx00-7859-014","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"145639","type":"LOCAL"},{"code":"203796","type":"LOCAL"}],"standard_charges":[{"gross_charge":275.0,"discounted_cash":140.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 145639 = Hospital System Supply Identifier | 203796 = Lawson ID"}]},{"description":"IMP DISTAL CENT 7859-15","code_information":[{"code":"Sx00-7859-015","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"167809","type":"LOCAL"},{"code":"203797","type":"LOCAL"}],"standard_charges":[{"gross_charge":275.0,"discounted_cash":140.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 167809 = Hospital System Supply Identifier | 203797 = Lawson ID"}]},{"description":"IMP DISTAL CENT 7859-16","code_information":[{"code":"Sx00-7859-016","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"145640","type":"LOCAL"},{"code":"203798","type":"LOCAL"}],"standard_charges":[{"gross_charge":275.0,"discounted_cash":140.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 145640 = Hospital System Supply Identifier | 203798 = Lawson ID"}]},{"description":"IMP DISTAL CENT 7859-17","code_information":[{"code":"Sx00-7859-017","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"323325","type":"LOCAL"},{"code":"203799","type":"LOCAL"}],"standard_charges":[{"gross_charge":275.0,"discounted_cash":140.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 323325 = Hospital System Supply Identifier | 203799 = Lawson ID"}]},{"description":"IMP DISTAL CENT 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32","code_information":[{"code":"Sx00-8851-013","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"327792","type":"LOCAL"},{"code":"426349","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 327792 = Hospital System Supply Identifier | 426349 = Lawson ID"}]},{"description":"IMP HIP ACET LNR NEUT LL 28","code_information":[{"code":"Sx00-8851-013","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"305541","type":"LOCAL"},{"code":"524487","type":"LOCAL"}],"standard_charges":[{"gross_charge":2365.0,"discounted_cash":1206.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: HCHB LOCATION | 305541 = Hospital System Supply Identifier | 524487 = Lawson ID"}]},{"description":"IMP HIP ACET LNR NEUT 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