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60X26MM","code_information":[{"code":"Sx00-5001-060","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"303199","type":"LOCAL"},{"code":"522145","type":"LOCAL"}],"standard_charges":[{"gross_charge":1914.0,"discounted_cash":803.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 303199 = Hospital System Supply Identifier | 522145 = Lawson ID"}]},{"description":"IMP HIP ACET LNR BPLR 60X32MM","code_information":[{"code":"Sx00-5001-060","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"303200","type":"LOCAL"},{"code":"522146","type":"LOCAL"}],"standard_charges":[{"gross_charge":1914.0,"discounted_cash":803.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 303200 = Hospital System Supply Identifier | 522146 = Lawson ID"}]},{"description":"SHELL MULTIPOLAR 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68X26MM","code_information":[{"code":"Sx00-5001-068","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"303205","type":"LOCAL"},{"code":"522151","type":"LOCAL"}],"standard_charges":[{"gross_charge":1914.0,"discounted_cash":803.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 303205 = Hospital System Supply Identifier | 522151 = Lawson ID"}]},{"description":"IMP HIP ACET LNR BPLR 68X32MM","code_information":[{"code":"Sx00-5001-068","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"303206","type":"LOCAL"},{"code":"522152","type":"LOCAL"}],"standard_charges":[{"gross_charge":1914.0,"discounted_cash":803.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 303206 = Hospital System Supply Identifier | 522152 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL BPLR 70MM","code_information":[{"code":"Sx00-5001-070","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"303207","type":"LOCAL"},{"code":"522153","type":"LOCAL"}],"standard_charges":[{"gross_charge":1914.0,"discounted_cash":803.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 303207 = Hospital System Supply Identifier | 522153 = Lawson ID"}]},{"description":"IMP HIP SHELL MULTPLR 72","code_information":[{"code":"Sx00-5001-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"326955","type":"LOCAL"},{"code":"408144","type":"LOCAL"}],"standard_charges":[{"gross_charge":1914.0,"discounted_cash":803.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 326955 = Hospital System Supply Identifier | 408144 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL BPLR 72MM","code_information":[{"code":"Sx00-5001-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"303208","type":"LOCAL"},{"code":"522154","type":"LOCAL"}],"standard_charges":[{"gross_charge":1914.0,"discounted_cash":803.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 303208 = Hospital System Supply Identifier | 522154 = Lawson ID"}]},{"description":"IMP HIP ACET LNR BPLR 72X26MM","code_information":[{"code":"Sx00-5001-072","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"303209","type":"LOCAL"},{"code":"522155","type":"LOCAL"}],"standard_charges":[{"gross_charge":1914.0,"discounted_cash":803.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 303209 = Hospital System Supply Identifier | 522155 = Lawson ID"}]},{"description":"IMP HIP ACET LNR BPLR 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14MM","code_information":[{"code":"Sx00-5952-021","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"192144","type":"LOCAL"},{"code":"223571","type":"LOCAL"}],"standard_charges":[{"gross_charge":4050.0,"discounted_cash":1701.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 192144 = Hospital System Supply Identifier | 223571 = Lawson ID"}]},{"description":"IMP TIB INS NXGN 3-4 10MM","code_information":[{"code":"Sx00-5952-030","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"146865","type":"LOCAL"},{"code":"223302","type":"LOCAL"}],"standard_charges":[{"gross_charge":4050.0,"discounted_cash":1701.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 146865 = Hospital System Supply Identifier | 223302 = Lawson ID"}]},{"description":"IMP TIB INS NXGN 3-4 12MM","code_information":[{"code":"Sx00-5952-030","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"146866","type":"LOCAL"},{"code":"223303","type":"LOCAL"}],"standard_charges":[{"gross_charge":4050.0,"discounted_cash":1701.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 146866 = Hospital System Supply Identifier | 223303 = Lawson ID"}]},{"description":"IMP TIB INS NXGN 3-4 14MM","code_information":[{"code":"Sx00-5952-030","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"146867","type":"LOCAL"},{"code":"223304","type":"LOCAL"}],"standard_charges":[{"gross_charge":4050.0,"discounted_cash":1701.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 146867 = Hospital System Supply Identifier | 223304 = Lawson ID"}]},{"description":"IMP TIB INS NXGN 5-6 10MM","code_information":[{"code":"Sx00-5952-040","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"146868","type":"LOCAL"},{"code":"223307","type":"LOCAL"}],"standard_charges":[{"gross_charge":4050.0,"discounted_cash":1701.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 146868 = Hospital System Supply Identifier | 223307 = Lawson ID"}]},{"description":"IMP TIB INS NXGN 5-6 12MM","code_information":[{"code":"Sx00-5952-040","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"179113","type":"LOCAL"},{"code":"223308","type":"LOCAL"}],"standard_charges":[{"gross_charge":4050.0,"discounted_cash":1701.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 179113 = Hospital System Supply Identifier | 223308 = Lawson ID"}]},{"description":"IMP TIB INS NXGN 5-6 14MM","code_information":[{"code":"Sx00-5952-040","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"146869","type":"LOCAL"},{"code":"223309","type":"LOCAL"}],"standard_charges":[{"gross_charge":4050.0,"discounted_cash":1701.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 146869 = Hospital System Supply Identifier | 223309 = Lawson ID"}]},{"description":"IMP TIB INS NXGN 7-10 12MM","code_information":[{"code":"Sx00-5952-050","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"179114","type":"LOCAL"},{"code":"223313","type":"LOCAL"}],"standard_charges":[{"gross_charge":4050.0,"discounted_cash":1701.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 179114 = Hospital System Supply Identifier | 223313 = Lawson ID"}]},{"description":"IMP TIB INS NXGN 7-10 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53.5X60MM","code_information":[{"code":"Sx00-5994-013","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"326349","type":"LOCAL"},{"code":"395769","type":"LOCAL"}],"standard_charges":[{"gross_charge":18486.0,"discounted_cash":7764.12,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 326349 = Hospital System Supply Identifier | 395769 = Lawson ID"}]},{"description":"IMP KNEE FEM COMP LCCK RT SZD","code_information":[{"code":"Sx00-5994-014","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"194972","type":"LOCAL"},{"code":"360631","type":"LOCAL"}],"standard_charges":[{"gross_charge":18486.0,"discounted_cash":7764.12,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 194972 = Hospital System Supply Identifier | 360631 = Lawson ID"}]},{"description":"IMP KNEE FEM COMP LCCK LT 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70.5X76.5","code_information":[{"code":"Sx00-5994-017","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"326350","type":"LOCAL"},{"code":"395770","type":"LOCAL"}],"standard_charges":[{"gross_charge":18486.0,"discounted_cash":7764.12,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 326350 = Hospital System Supply Identifier | 395770 = Lawson ID"}]},{"description":"IMP KNEE TIB INS NXGN MIC","code_information":[{"code":"Sx00-5994-022","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"327175","type":"LOCAL"},{"code":"412372","type":"LOCAL"}],"standard_charges":[{"gross_charge":8974.5,"discounted_cash":3769.29,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 327175 = Hospital System Supply Identifier | 412372 = Lawson ID"}]},{"description":"IMP TIB NXGN SZ1-2 23MM","code_information":[{"code":"Sx00-5994-022","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"198028","type":"LOCAL"},{"code":"443264","type":"LOCAL"}],"standard_charges":[{"gross_charge":8974.5,"discounted_cash":3769.29,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 198028 = Hospital System Supply Identifier | 443264 = Lawson ID"}]},{"description":"IMP KNEE INS NXGN LOK CD1-2/12","code_information":[{"code":"Sx00-5994-022","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"202243","type":"LOCAL"},{"code":"452341","type":"LOCAL"}],"standard_charges":[{"gross_charge":8974.5,"discounted_cash":3769.29,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 202243 = Hospital System Supply Identifier | 452341 = Lawson ID"}]},{"description":"IMP KNEE INS NXGN LOK CD1-2/17","code_information":[{"code":"Sx00-5994-022","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"202244","type":"LOCAL"},{"code":"452342","type":"LOCAL"}],"standard_charges":[{"gross_charge":8974.5,"discounted_cash":3769.29,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 202244 = Hospital System Supply Identifier | 452342 = Lawson ID"}]},{"description":"IMP KNEE INS NXGN LOK CD1-2/20","code_information":[{"code":"Sx00-5994-022","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"202245","type":"LOCAL"},{"code":"452343","type":"LOCAL"}],"standard_charges":[{"gross_charge":8974.5,"discounted_cash":3769.29,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 202245 = Hospital System Supply Identifier | 452343 = Lawson ID"}]},{"description":"IMP KNEE SURF ARTC CD 1-2 10","code_information":[{"code":"Sx00-5994-022","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"322047","type":"LOCAL"},{"code":"535261","type":"LOCAL"}],"standard_charges":[{"gross_charge":8974.5,"discounted_cash":3769.29,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 322047 = Hospital System Supply Identifier | 535261 = 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":8974.5,"discounted_cash":3769.29,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 322051 = Hospital System Supply Identifier | 535265 = Lawson ID"}]},{"description":"IMP KNEE SURF ARTC CD 3-4 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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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 167756 = Hospital System Supply Identifier | 203496 = Lawson ID"}]},{"description":"LINER ACETAB 32M 10 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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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 304267 = Hospital System Supply Identifier | 523224 = 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 159043 = Hospital System Supply Identifier | 325078 = 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 304266 = Hospital System Supply Identifier | 523223 = 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 167754 = Hospital System Supply Identifier | 203494 = 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 328962 = Hospital System Supply Identifier | 206429 = 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 167753 = Hospital System Supply Identifier | 203493 = Lawson ID"}]},{"description":"LINER ACETAB 32M 10 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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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 304270 = Hospital System Supply Identifier | 523227 = 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 324846 = Hospital System Supply Identifier | 324310 = 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 167752 = Hospital System Supply Identifier | 203489 = 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 328924 = Hospital System Supply Identifier | 203490 = Lawson ID"}]},{"description":"LINER ACETAB 32M 10 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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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":6424.88,"discounted_cash":2698.45,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":6424.88,"discounted_cash":2698.45,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":6424.88,"discounted_cash":2698.45,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":6424.88,"discounted_cash":2698.45,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 304315 = Hospital System Supply Identifier | 523272 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 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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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":6424.88,"discounted_cash":2698.45,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 304319 = Hospital System Supply Identifier | 523276 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 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64X32","code_information":[{"code":"Sx00-6320-064","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"325148","type":"LOCAL"},{"code":"340105","type":"LOCAL"}],"standard_charges":[{"gross_charge":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 325148 = Hospital System Supply Identifier | 340105 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 64X22","code_information":[{"code":"Sx00-6320-064","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304335","type":"LOCAL"},{"code":"523292","type":"LOCAL"}],"standard_charges":[{"gross_charge":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 304335 = Hospital System Supply Identifier | 523292 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 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66X28","code_information":[{"code":"Sx00-6320-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304340","type":"LOCAL"},{"code":"523297","type":"LOCAL"}],"standard_charges":[{"gross_charge":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 304340 = Hospital System Supply Identifier | 523297 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 66X22","code_information":[{"code":"Sx00-6320-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304338","type":"LOCAL"},{"code":"523295","type":"LOCAL"}],"standard_charges":[{"gross_charge":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 304338 = Hospital System Supply Identifier | 523295 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 20D 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44X28","code_information":[{"code":"Sx00-6341-044","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"326734","type":"LOCAL"},{"code":"408177","type":"LOCAL"}],"standard_charges":[{"gross_charge":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 326734 = Hospital System Supply Identifier | 408177 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 7MM OFF 46X28","code_information":[{"code":"Sx00-6341-046","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"304375","type":"LOCAL"},{"code":"523332","type":"LOCAL"}],"standard_charges":[{"gross_charge":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 304375 = Hospital System Supply Identifier | 523332 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 7MM OFF 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28M","code_information":[{"code":"Sx00-6341-050","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328977","type":"LOCAL"},{"code":"206459","type":"LOCAL"}],"standard_charges":[{"gross_charge":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 328977 = Hospital System Supply Identifier | 206459 = Lawson ID"}]},{"description":"LINER LONGEVITY 7MM OFFSET","code_information":[{"code":"Sx00-6341-050","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"329002","type":"LOCAL"},{"code":"208732","type":"LOCAL"}],"standard_charges":[{"gross_charge":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 329002 = Hospital System Supply Identifier | 208732 = Lawson ID"}]},{"description":"LINER LONGEVITY 7MM OFFSET 28M","code_information":[{"code":"Sx00-6341-056","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328978","type":"LOCAL"},{"code":"206460","type":"LOCAL"}],"standard_charges":[{"gross_charge":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 328978 = Hospital System Supply Identifier | 206460 = Lawson ID"}]},{"description":"LINER LONGEVITY 7MM OFFSET 32M","code_information":[{"code":"Sx00-6341-056","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328983","type":"LOCAL"},{"code":"206465","type":"LOCAL"}],"standard_charges":[{"gross_charge":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 328983 = Hospital System Supply Identifier | 206465 = Lawson ID"}]},{"description":"LINER LONGEVITY 7MM OFFSET 32M","code_information":[{"code":"Sx00-6341-058","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328984","type":"LOCAL"},{"code":"206466","type":"LOCAL"}],"standard_charges":[{"gross_charge":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 328984 = Hospital System Supply Identifier | 206466 = Lawson ID"}]},{"description":"LINER LONGEVITY 7MM OFFSET 28M","code_information":[{"code":"Sx00-6341-058","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328979","type":"LOCAL"},{"code":"206461","type":"LOCAL"}],"standard_charges":[{"gross_charge":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 328979 = Hospital System Supply Identifier | 206461 = Lawson ID"}]},{"description":"LINER LONGEVITY 7MM OFFSET 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28M","code_information":[{"code":"Sx00-6341-064","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328982","type":"LOCAL"},{"code":"206464","type":"LOCAL"}],"standard_charges":[{"gross_charge":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 328982 = Hospital System Supply Identifier | 206464 = Lawson ID"}]},{"description":"LINER LONGEVITY 7MM OFFSET 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 328987 = Hospital System Supply Identifier | 206469 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 7MM OFF 66X28","code_information":[{"code":"Sx00-6341-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"326736","type":"LOCAL"},{"code":"408179","type":"LOCAL"}],"standard_charges":[{"gross_charge":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 326736 = Hospital System Supply Identifier | 408179 = Lawson ID"}]},{"description":"LINER LONGEVITY 7MM OFFSET 32M","code_information":[{"code":"Sx00-6341-068","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"328988","type":"LOCAL"},{"code":"206470","type":"LOCAL"}],"standard_charges":[{"gross_charge":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 328988 = Hospital System Supply Identifier | 206470 = Lawson ID"}]},{"description":"IMP HIP ACET LNR 7MM OFF 68X28","code_information":[{"code":"Sx00-6341-068","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"326737","type":"LOCAL"},{"code":"408180","type":"LOCAL"}],"standard_charges":[{"gross_charge":3712.5,"discounted_cash":1559.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 326737 = Hospital System Supply Identifier | 408180 = Lawson ID"}]},{"description":"LINER LONGEVITY 7MM OFFSET 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54MM","code_information":[{"code":"Sx00-7053-054","type":"CDM"},{"code":"272","type":"RC"},{"code":"167165","type":"LOCAL"},{"code":"159170","type":"LOCAL"}],"standard_charges":[{"gross_charge":3780.0,"discounted_cash":1587.6,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 167165 = Hospital System Supply Identifier | 159170 = Lawson ID"}]},{"description":"BLADE EXPLANT FULL 56MM","code_information":[{"code":"Sx00-7053-056","type":"CDM"},{"code":"272","type":"RC"},{"code":"191900","type":"LOCAL"},{"code":"159171","type":"LOCAL"}],"standard_charges":[{"gross_charge":3780.0,"discounted_cash":1587.6,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 191900 = Hospital System Supply Identifier | 159171 = Lawson ID"}]},{"description":"BLADE EXPLANT TRUN 56MM","code_information":[{"code":"Sx00-7053-056","type":"CDM"},{"code":"272","type":"RC"},{"code":"192036","type":"LOCAL"},{"code":"210139","type":"LOCAL"}],"standard_charges":[{"gross_charge":3780.0,"discounted_cash":1587.6,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 192036 = Hospital System Supply Identifier | 210139 = Lawson ID"}]},{"description":"BLADE EXPLANT TRUN 58MM","code_information":[{"code":"Sx00-7053-058","type":"CDM"},{"code":"272","type":"RC"},{"code":"168606","type":"LOCAL"},{"code":"210140","type":"LOCAL"}],"standard_charges":[{"gross_charge":3780.0,"discounted_cash":1587.6,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 168606 = Hospital System Supply Identifier | 210140 = Lawson ID"}]},{"description":"BLADE EXPLANT FULL 58MM","code_information":[{"code":"Sx00-7053-058","type":"CDM"},{"code":"272","type":"RC"},{"code":"192038","type":"LOCAL"},{"code":"210144","type":"LOCAL"}],"standard_charges":[{"gross_charge":3780.0,"discounted_cash":1587.6,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 192038 = Hospital System Supply Identifier | 210144 = Lawson ID"}]},{"description":"BLADE EXPLANT TRUN 60MM","code_information":[{"code":"Sx00-7053-060","type":"CDM"},{"code":"272","type":"RC"},{"code":"192037","type":"LOCAL"},{"code":"210141","type":"LOCAL"}],"standard_charges":[{"gross_charge":3780.0,"discounted_cash":1587.6,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 192037 = Hospital System Supply Identifier | 210141 = Lawson ID"}]},{"description":"BLADE EXPLANT FULL 60MM","code_information":[{"code":"Sx00-7053-060","type":"CDM"},{"code":"272","type":"RC"},{"code":"192039","type":"LOCAL"},{"code":"210145","type":"LOCAL"}],"standard_charges":[{"gross_charge":3780.0,"discounted_cash":1587.6,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 192039 = Hospital System Supply Identifier | 210145 = Lawson ID"}]},{"description":"BLADE EXPLANT FULL 62MM","code_information":[{"code":"Sx00-7053-062","type":"CDM"},{"code":"272","type":"RC"},{"code":"95112","type":"LOCAL"},{"code":"310998","type":"LOCAL"}],"standard_charges":[{"gross_charge":3780.0,"discounted_cash":1587.6,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 95112 = Hospital System Supply Identifier | 310998 = Lawson ID"}]},{"description":"BLADE EXPLANT TRUN 62MM","code_information":[{"code":"Sx00-7053-062","type":"CDM"},{"code":"272","type":"RC"},{"code":"95111","type":"LOCAL"},{"code":"310991","type":"LOCAL"}],"standard_charges":[{"gross_charge":3780.0,"discounted_cash":1587.6,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 95111 = Hospital System Supply Identifier | 310991 = Lawson ID"}]},{"description":"BLADE EXPLANT FULL 64MM","code_information":[{"code":"Sx00-7053-064","type":"CDM"},{"code":"272","type":"RC"},{"code":"192041","type":"LOCAL"},{"code":"210147","type":"LOCAL"}],"standard_charges":[{"gross_charge":3780.0,"discounted_cash":1587.6,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 192041 = Hospital System Supply Identifier | 210147 = Lawson ID"}]},{"description":"BLADE EXPLANT TRUN 64MM","code_information":[{"code":"Sx00-7053-064","type":"CDM"},{"code":"272","type":"RC"},{"code":"192040","type":"LOCAL"},{"code":"210146","type":"LOCAL"}],"standard_charges":[{"gross_charge":3780.0,"discounted_cash":1587.6,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 192040 = Hospital System Supply Identifier | 210146 = 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":3780.0,"discounted_cash":1587.6,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 193493 = Hospital System Supply Identifier | 310992 = Lawson ID"}]},{"description":"BLADE EXPLANT FULL 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":3780.0,"discounted_cash":1587.6,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 193497 = Hospital System Supply Identifier | 310999 = 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":3780.0,"discounted_cash":1587.6,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3780.0,"discounted_cash":1587.6,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3780.0,"discounted_cash":1587.6,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3780.0,"discounted_cash":1587.6,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3780.0,"discounted_cash":1587.6,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":3780.0,"discounted_cash":1587.6,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320930 = Hospital System Supply Identifier | 534144 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 195289 = Hospital System Supply Identifier | 372221 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320931 = Hospital System Supply Identifier | 534145 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320933 = Hospital System Supply Identifier | 534147 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320934 = Hospital System Supply Identifier | 534148 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320937 = Hospital System Supply Identifier | 534151 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320938 = Hospital System Supply Identifier | 534152 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320940 = Hospital System Supply Identifier | 534154 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320944 = Hospital System Supply Identifier | 534158 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320942 = Hospital System Supply Identifier | 534156 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320948 = Hospital System Supply Identifier | 534162 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320946 = Hospital System Supply Identifier | 534160 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320954 = Hospital System Supply Identifier | 534168 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 202100 = Hospital System Supply Identifier | 452196 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320955 = Hospital System Supply Identifier | 534169 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320958 = Hospital System Supply Identifier | 534172 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 202101 = Hospital System Supply Identifier | 452197 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320961 = Hospital System Supply Identifier | 534175 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320959 = Hospital System Supply Identifier | 534173 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320962 = Hospital System Supply Identifier | 534176 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320963 = Hospital System Supply Identifier | 534177 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 194975 = Hospital System Supply Identifier | 360636 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 202102 = Hospital System Supply Identifier | 452198 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320967 = Hospital System Supply Identifier | 534181 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320971 = Hospital System Supply Identifier | 534185 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320970 = Hospital System Supply Identifier | 534184 = 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320969 = Hospital System Supply Identifier | 534183 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL 28X50MM","code_information":[{"code":"Sx00-7115-050","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"196301","type":"LOCAL"},{"code":"408185","type":"LOCAL"}],"standard_charges":[{"gross_charge":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 196301 = Hospital System Supply Identifier | 408185 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL TM 52X28","code_information":[{"code":"Sx00-7115-052","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320972","type":"LOCAL"},{"code":"534186","type":"LOCAL"}],"standard_charges":[{"gross_charge":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320972 = Hospital System Supply Identifier | 534186 = Lawson ID"}]},{"description":"IMP HIP LNR CNSTRN CEM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320974 = Hospital System Supply Identifier | 534188 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL TM 62-64X36","code_information":[{"code":"Sx00-7115-062","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"325646","type":"LOCAL"},{"code":"360637","type":"LOCAL"}],"standard_charges":[{"gross_charge":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 325646 = Hospital System Supply Identifier | 360637 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL 66/68/70X36","code_information":[{"code":"Sx00-7115-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"320975","type":"LOCAL"},{"code":"534189","type":"LOCAL"}],"standard_charges":[{"gross_charge":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320975 = Hospital System Supply Identifier | 534189 = Lawson ID"}]},{"description":"IMP HIP ACET SHELL TM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9264.0,"discounted_cash":3890.88,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 320977 = Hospital System Supply Identifier | 534191 = Lawson ID"}]},{"description":"IMP ACET CAGE SHRT FLG RT","code_information":[{"code":"Sx00-7123-056","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"327052","type":"LOCAL"},{"code":"409658","type":"LOCAL"}],"standard_charges":[{"gross_charge":9835.0,"discounted_cash":4130.7,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 327052 = Hospital System Supply Identifier | 409658 = Lawson ID"}]},{"description":"IMP HIP CAGE SHRT RT 62/64","code_information":[{"code":"Sx00-7123-062","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"321695","type":"LOCAL"},{"code":"534909","type":"LOCAL"}],"standard_charges":[{"gross_charge":9835.0,"discounted_cash":4130.7,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 321695 = Hospital System Supply Identifier | 534909 = Lawson ID"}]},{"description":"IMP HIP ACET CAGE 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":9835.0,"discounted_cash":4130.7,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9835.0,"discounted_cash":4130.7,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9835.0,"discounted_cash":4130.7,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM 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":9835.0,"discounted_cash":4130.7,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 321697 = Hospital System Supply Identifier | 534911 = Lawson ID"}]},{"description":"IMP HIP CAGE SHRT LT 62/64","code_information":[{"code":"Sx00-7124-062","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"321698","type":"LOCAL"},{"code":"534912","type":"LOCAL"}],"standard_charges":[{"gross_charge":9835.0,"discounted_cash":4130.7,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 321698 = Hospital System Supply Identifier | 534912 = Lawson ID"}]},{"description":"IMP HIP CAGE SHRT LT 66/68/70","code_information":[{"code":"Sx00-7124-066","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1776","type":"HCPCS"},{"code":"321699","type":"LOCAL"},{"code":"534913","type":"LOCAL"}],"standard_charges":[{"gross_charge":9835.0,"discounted_cash":4130.7,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 321699 = Hospital System Supply Identifier | 534913 = Lawson ID"}]},{"description":"IMP HIP CAGE SHRT LT 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":9835.0,"discounted_cash":4130.7,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 321700 = Hospital System Supply Identifier | 534914 = Lawson ID"}]},{"description":"IMP HIP SHELL TM SHRT CAGE 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INSPIRE","code_information":[{"code":"Sx00000004063","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1778","type":"HCPCS"},{"code":"709293","type":"LOCAL"},{"code":"726032","type":"LOCAL"}],"standard_charges":[{"gross_charge":10959.0,"discounted_cash":4602.78,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 709293 = Hospital System Supply Identifier | 726032 = Lawson ID"}]},{"description":"LEAD CPI FLEXTEND 4086","code_information":[{"code":"Sx00000004086","type":"CDM"},{"code":"275","type":"RC"},{"code":"C1898","type":"HCPCS"},{"code":"192016","type":"LOCAL"},{"code":"207810","type":"LOCAL"}],"standard_charges":[{"gross_charge":2063.1,"discounted_cash":866.5,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 192016 = Hospital System Supply Identifier | 207810 = Lawson ID"}]},{"description":"LEAD CPI FLEXTEND 4087","code_information":[{"code":"Sx00000004087","type":"CDM"},{"code":"275","type":"RC"},{"code":"C1898","type":"HCPCS"},{"code":"192017","type":"LOCAL"},{"code":"207812","type":"LOCAL"}],"standard_charges":[{"gross_charge":2063.1,"discounted_cash":866.5,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 192017 = Hospital System Supply Identifier | 207812 = Lawson ID"}]},{"description":"LEAD FLEXTEND 4088 59CM","code_information":[{"code":"Sx00000004088","type":"CDM"},{"code":"275","type":"RC"},{"code":"C1898","type":"HCPCS"},{"code":"192218","type":"LOCAL"},{"code":"238839","type":"LOCAL"}],"standard_charges":[{"gross_charge":2063.1,"discounted_cash":866.5,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 192218 = Hospital System Supply Identifier | 238839 = Lawson ID"}]},{"description":"NEUROSTIMULATOR NONCHAREABLE SACRAL","code_information":[{"code":"Sx00000004101","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1767","type":"HCPCS"},{"code":"1125335","type":"LOCAL"}],"standard_charges":[{"gross_charge":46989.0,"discounted_cash":19735.38,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 1125335 = Hospital System Supply Identifier"}]},{"description":"DISC - FIXATOR EBI WRST","code_information":[{"code":"Sx00000004103","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1713","type":"HCPCS"},{"code":"73884","type":"LOCAL"},{"code":"259420","type":"LOCAL"}],"standard_charges":[{"gross_charge":9669.3,"discounted_cash":4061.11,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 73884 = Hospital System Supply Identifier | 259420 = Lawson ID"}]},{"description":"KIT PROCEDURE ECTRA 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4136","code_information":[{"code":"Sx00000004136","type":"CDM"},{"code":"275","type":"RC"},{"code":"C1898","type":"HCPCS"},{"code":"146006","type":"LOCAL"},{"code":"301224","type":"LOCAL"}],"standard_charges":[{"gross_charge":2063.1,"discounted_cash":866.5,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 146006 = Hospital System Supply Identifier | 301224 = Lawson ID"}]},{"description":"LEAD DEXTRUS 4137","code_information":[{"code":"Sx00000004137","type":"CDM"},{"code":"275","type":"RC"},{"code":"C1898","type":"HCPCS"},{"code":"146007","type":"LOCAL"},{"code":"301225","type":"LOCAL"}],"standard_charges":[{"gross_charge":2063.1,"discounted_cash":866.5,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 146007 = Hospital System Supply Identifier | 301225 = Lawson ID"}]},{"description":"LEAD RESPIRATORY STIMULATION RESPISTIM LQS 4165 65CM","code_information":[{"code":"Sx00000004165","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1778","type":"HCPCS"},{"code":"1444660","type":"LOCAL"},{"code":"1096211","type":"LOCAL"}],"standard_charges":[{"gross_charge":40860.0,"discounted_cash":17161.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 1444660 = Hospital System Supply Identifier | 1096211 = Lawson ID"}]},{"description":"LINE ASPIR/ANTICOAG 3/8IN","code_information":[{"code":"Sx00000004197","type":"CDM"},{"code":"272","type":"RC"},{"code":"795636","type":"LOCAL"},{"code":"775105","type":"LOCAL"}],"standard_charges":[{"gross_charge":805.45,"discounted_cash":338.29,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 795636 = Hospital System Supply Identifier | 775105 = Lawson ID"}]},{"description":"GWIRE EZGLIDR .035X150CM STRL","code_information":[{"code":"Sx000000041BX","type":"CDM"},{"code":"272","type":"RC"},{"code":"C1769","type":"HCPCS"},{"code":"198527","type":"LOCAL"},{"code":"443821","type":"LOCAL"}],"standard_charges":[{"gross_charge":478.53,"discounted_cash":200.98,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 198527 = Hospital System Supply Identifier | 443821 = Lawson ID"}]},{"description":"CLIP LIG HORZ TI LG","code_information":[{"code":"Sx00000004200","type":"CDM"},{"code":"KT","type":"RC"},{"code":"18318","type":"LOCAL"},{"code":"203539","type":"LOCAL"}],"standard_charges":[{"gross_charge":78.0,"discounted_cash":32.76,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 18318 = Hospital System Supply Identifier | 203539 = Lawson ID"}]},{"description":"HEMOCLIP TI HORIZON LG 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5.5X145MM","code_information":[{"code":"Sx00000004250","type":"CDM"},{"code":"272","type":"RC"},{"code":"176565","type":"LOCAL"},{"code":"221917","type":"LOCAL"}],"standard_charges":[{"gross_charge":8829.75,"discounted_cash":3708.5,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 176565 = Hospital System Supply Identifier | 221917 = Lawson ID"}]},{"description":"SET BOWL CELL SAVER 55","code_information":[{"code":"Sx00000004250","type":"CDM"},{"code":"272","type":"RC"},{"code":"400316","type":"LOCAL"},{"code":"636996","type":"LOCAL"}],"standard_charges":[{"gross_charge":1129.2,"discounted_cash":474.26,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 400316 = Hospital System Supply Identifier | 636996 = Lawson ID"}]},{"description":"SET BOWL CELL SAVER 125","code_information":[{"code":"Sx00000004251","type":"CDM"},{"code":"272","type":"RC"},{"code":"400317","type":"LOCAL"},{"code":"636997","type":"LOCAL"}],"standard_charges":[{"gross_charge":1129.2,"discounted_cash":474.26,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 400317 = Hospital System Supply Identifier | 636997 = Lawson ID"}]},{"description":"SET BOWL XTRA 175ML","code_information":[{"code":"Sx00000004252","type":"CDM"},{"code":"272","type":"RC"},{"code":"795637","type":"LOCAL"},{"code":"775106","type":"LOCAL"}],"standard_charges":[{"gross_charge":1129.2,"discounted_cash":474.26,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 795637 = Hospital System Supply Identifier | 775106 = Lawson ID"}]},{"description":"SET BOWL CELL SAVER 225","code_information":[{"code":"Sx00000004253","type":"CDM"},{"code":"272","type":"RC"},{"code":"354024","type":"LOCAL"},{"code":"591212","type":"LOCAL"}],"standard_charges":[{"gross_charge":1129.2,"discounted_cash":474.26,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 354024 = Hospital System Supply Identifier | 591212 = Lawson ID"}]},{"description":"SET CELLSAVER XTRA TX/225CC","code_information":[{"code":"Sx00000004257","type":"CDM"},{"code":"272","type":"RC"},{"code":"454360","type":"LOCAL"},{"code":"575624","type":"LOCAL"}],"standard_charges":[{"gross_charge":1797.64,"discounted_cash":755.01,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 454360 = Hospital System Supply Identifier | 575624 = Lawson ID"}]},{"description":"RESERVOIR BLD COLL XRES B","code_information":[{"code":"Sx00000004259","type":"CDM"},{"code":"272","type":"RC"},{"code":"795638","type":"LOCAL"},{"code":"775107","type":"LOCAL"}],"standard_charges":[{"gross_charge":529.0,"discounted_cash":222.18,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 795638 = Hospital System Supply Identifier | 775107 = Lawson ID"}]},{"description":"DISC - SET BOWL CELL SAVER RESVR 40MM","code_information":[{"code":"Sx00000004260","type":"CDM"},{"code":"272","type":"RC"},{"code":"400318","type":"LOCAL"},{"code":"636998","type":"LOCAL"}],"standard_charges":[{"gross_charge":646.64,"discounted_cash":271.59,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 400318 = Hospital System Supply Identifier | 636998 = Lawson ID"}]},{"description":"SET PROC BX/55","code_information":[{"code":"Sx00000004261","type":"CDM"},{"code":"272","type":"RC"},{"code":"795639","type":"LOCAL"},{"code":"775108","type":"LOCAL"}],"standard_charges":[{"gross_charge":1944.07,"discounted_cash":816.51,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 795639 = Hospital System Supply Identifier | 775108 = Lawson ID"}]},{"description":"SET PROC BX/125","code_information":[{"code":"Sx00000004262","type":"CDM"},{"code":"272","type":"RC"},{"code":"795640","type":"LOCAL"},{"code":"775109","type":"LOCAL"}],"standard_charges":[{"gross_charge":1944.07,"discounted_cash":816.51,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 795640 = Hospital System Supply Identifier | 775109 = Lawson ID"}]},{"description":"SET PROC BX/175","code_information":[{"code":"Sx00000004263","type":"CDM"},{"code":"272","type":"RC"},{"code":"795641","type":"LOCAL"},{"code":"775110","type":"LOCAL"}],"standard_charges":[{"gross_charge":1944.07,"discounted_cash":816.51,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 795641 = Hospital System Supply Identifier | 775110 = Lawson ID"}]},{"description":"SET PROC BX/225","code_information":[{"code":"Sx00000004264","type":"CDM"},{"code":"272","type":"RC"},{"code":"795642","type":"LOCAL"},{"code":"775111","type":"LOCAL"}],"standard_charges":[{"gross_charge":1831.92,"discounted_cash":769.41,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 795642 = Hospital System Supply Identifier | 775111 = Lawson ID"}]},{"description":"SET COLL BX","code_information":[{"code":"Sx00000004265","type":"CDM"},{"code":"272","type":"RC"},{"code":"795643","type":"LOCAL"},{"code":"775112","type":"LOCAL"}],"standard_charges":[{"gross_charge":833.17,"discounted_cash":349.93,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 795643 = Hospital System Supply Identifier | 775112 = Lawson ID"}]},{"description":"SET COLL TX CARDIO","code_information":[{"code":"Sx00000004266","type":"CDM"},{"code":"272","type":"RC"},{"code":"795644","type":"LOCAL"},{"code":"775113","type":"LOCAL"}],"standard_charges":[{"gross_charge":846.4,"discounted_cash":355.49,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 795644 = Hospital System Supply Identifier | 775113 = Lawson ID"}]},{"description":"SET COLL BX CARDIO","code_information":[{"code":"Sx00000004267","type":"CDM"},{"code":"272","type":"RC"},{"code":"795645","type":"LOCAL"},{"code":"775114","type":"LOCAL"}],"standard_charges":[{"gross_charge":846.4,"discounted_cash":355.49,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 795645 = Hospital System Supply Identifier | 775114 = Lawson ID"}]},{"description":"HOLDER RESERVOIR PERFUSION CARDIOTOMY BLOOD COLLECTION XRES 04272","code_information":[{"code":"Sx00000004272","type":"CDM"},{"code":"272","type":"RC"},{"code":"1531023","type":"LOCAL"},{"code":"1104783","type":"LOCAL"}],"standard_charges":[{"gross_charge":6418.94,"discounted_cash":2695.95,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 1531023 = Hospital System Supply Identifier | 1104783 = Lawson ID"}]},{"description":"RESERVOIR BLD COLL XRES B 120","code_information":[{"code":"Sx00000004275","type":"CDM"},{"code":"272","type":"RC"},{"code":"795647","type":"LOCAL"},{"code":"775116","type":"LOCAL"}],"standard_charges":[{"gross_charge":575.86,"discounted_cash":241.86,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 795647 = Hospital System Supply Identifier | 775116 = Lawson ID"}]},{"description":"SET COLL BX CARDIO 120UM","code_information":[{"code":"Sx00000004277","type":"CDM"},{"code":"272","type":"RC"},{"code":"795648","type":"LOCAL"},{"code":"775117","type":"LOCAL"}],"standard_charges":[{"gross_charge":972.09,"discounted_cash":408.28,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 795648 = Hospital System Supply Identifier | 775117 = Lawson ID"}]},{"description":"SET PROC BX/225 120UM","code_information":[{"code":"Sx00000004278","type":"CDM"},{"code":"272","type":"RC"},{"code":"795649","type":"LOCAL"},{"code":"775118","type":"LOCAL"}],"standard_charges":[{"gross_charge":1944.07,"discounted_cash":816.51,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 795649 = Hospital System Supply Identifier | 775118 = Lawson ID"}]},{"description":"DISC - CATH IMPELLA RP","code_information":[{"code":"Sx00000004334","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1889","type":"HCPCS"},{"code":"473003","type":"LOCAL"},{"code":"595771","type":"LOCAL"}],"standard_charges":[{"gross_charge":107000.0,"discounted_cash":44940.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 473003 = Hospital System Supply Identifier | 595771 = Lawson ID"}]},{"description":"LEAD SNSE AIRWAY UPPER INSPIRE","code_information":[{"code":"Sx00000004340","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1778","type":"HCPCS"},{"code":"709294","type":"LOCAL"},{"code":"726033","type":"LOCAL"}],"standard_charges":[{"gross_charge":16470.0,"discounted_cash":6917.4,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 709294 = Hospital System Supply Identifier | 726033 = Lawson ID"}]},{"description":"BARRIER ADH INTERCEED 3X4IN","code_information":[{"code":"Sx00000004350","type":"CDM"},{"code":"278","type":"RC"},{"code":"C1889","type":"HCPCS"},{"code":"20936","type":"LOCAL"},{"code":"104075","type":"LOCAL"}],"standard_charges":[{"gross_charge":3667.29,"discounted_cash":1540.26,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 20936 = Hospital System Supply Identifier | 104075 = Lawson ID"}]},{"description":"BOWL SET CORONARY PERFUSION MINIMAL BLEEDING SM XTRA 04350 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175ML","code_information":[{"code":"Sx00000004356","type":"CDM"},{"code":"272","type":"RC"},{"code":"1531015","type":"LOCAL"},{"code":"1104721","type":"LOCAL"}],"standard_charges":[{"gross_charge":1944.07,"discounted_cash":816.51,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 1531015 = Hospital System Supply Identifier | 1104721 = Lawson ID"}]},{"description":"PROCEDURE SET CORONARY PERFUSION TX CARD BOWL XTRA 04357 225ML","code_information":[{"code":"Sx00000004357","type":"CDM"},{"code":"272","type":"RC"},{"code":"1531022","type":"LOCAL"},{"code":"1104780","type":"LOCAL"}],"standard_charges":[{"gross_charge":1797.64,"discounted_cash":755.01,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 1531022 = Hospital System Supply Identifier | 1104780 = Lawson ID"}]},{"description":"RESERVOIR PERFUSION CARDIOTOMY TOP OUTLET BLOOD XTRA XRES 04358","code_information":[{"code":"Sx00000004358","type":"CDM"},{"code":"272","type":"RC"},{"code":"1531014","type":"LOCAL"},{"code":"1104700","type":"LOCAL"}],"standard_charges":[{"gross_charge":551.0,"discounted_cash":231.42,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 1531014 = Hospital System Supply Identifier | 1104700 = Lawson ID"}]},{"description":"RESERVOIR PERFUSION CARDIOTOMY BOTTOM OUTLET BLOOD XTRA XRES 04359","code_information":[{"code":"Sx00000004359","type":"CDM"},{"code":"272","type":"RC"},{"code":"1531026","type":"LOCAL"},{"code":"1104818","type":"LOCAL"}],"standard_charges":[{"gross_charge":529.0,"discounted_cash":222.18,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: TTM LOCATION | 1531026 = Hospital System Supply Identifier | 1104818 = Lawson ID"}]},{"description":"COLLECTION SET CORONARY PERFUSION TX XTRA 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