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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | LOCOID(R) TOPICAL OINTMENT 0.1% | 701211 | 22.65 | ||||
0 | LOMIR SPRO(R) ORAL CAPSUL 5 mg | 701212 | 2.33 | ||||
0 | LOMIR(R) ORAL TABLET 2.5 mg | 701213 | 1.54 | ||||
0 | LOMIR(R) ORAL TABLET 400 mg | 701214 | 1.54 | ||||
0 | LOPRESOR(R) ORAL TABLET 50 mg 40 Tab | 701215 | 544051207 | 0.69 | |||
0 | LORINE ORAL TABLET 10 mg Tab | 701216 | 1.77 | ||||
0 | LOSEC(R) Intra-Venus VIAL 40 mg Vial | 701217 | 546031238 | 44.35 | |||
0 | LOSEC(R) ORAL CAPSUL 20 mg 14 Capsule | 701218 | 546031236 | 8.54 | |||
0 | LOTENSE Oral Tablet 5 mg 30 ??? | 701219 | 544031097 | 1.78 | |||
0 | LOVRAK(R) Oral Suspension 200 mg / 5 ml | 701220 | 540051762 | 110.7 | |||
0 | LOVRAK(R) Topical Cream 5% 10 ????? | 701221 | 550063700 | 64.6 | |||
0 | LOVRAK(R) Topical Ointment 5 % 10 ????? | 701222 | 550063700 | 64.6 |
LOCOID(R) TOPICAL OINTMENT 0.1%
22.65
LOMIR SPRO(R) ORAL CAPSUL 5 mg
2.33
LOMIR(R) ORAL TABLET 2.5 mg
1.54
LOMIR(R) ORAL TABLET 400 mg
1.54
LOPRESOR(R) ORAL TABLET 50 mg 40 Tab
0.69
LORINE ORAL TABLET 10 mg Tab
1.77
LOSEC(R) Intra-Venus VIAL 40 mg Vial
44.35
LOSEC(R) ORAL CAPSUL 20 mg 14 Capsule
8.54
LOTENSE Oral Tablet 5 mg 30 ???
1.78
LOVRAK(R) Oral Suspension 200 mg / 5 ml
110.7
LOVRAK(R) Topical Cream 5% 10 ?????
64.6
LOVRAK(R) Topical Ointment 5 % 10 ?????
64.6
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