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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | HEPSAL(R) Intra-Venus AMPOULE 10 I.U./ml | 700979 | 2.7 | ||||
0 | HERCEPTIN Intra-Venus VIAL 150 MG 1 | 700980 | 541014081 | 3,755.55 | |||
0 | HIBERIX(R) Intra-Venus VIAL 10 mcg/Dose | 700981 | 67.35 | ||||
0 | HIBITANE OBESTET(R) TOPICAL CREAM 1% | 700982 | 6.85 | ||||
0 | HICONCIL(R) ORAL CAPSUL 250 mg | 700983 | 1.12 | ||||
0 | HICONCIL(R) ORAL CAPSUL 500 mg | 700984 | 2.25 | ||||
0 | HISTAFED(R) ORAL TABLET 2.5+60 mg 30 Tab | 700985 | 549062570 | 0.3 | |||
0 | HISTALOC(R) ORAL TABLET 10 mg | 700986 | 0.13 | ||||
0 | HISTOL (R) ORAL SYRUP 1.25+30 mg/ml Syrups | 700987 | 549062550 | 5.65 | |||
0 | HISTOP(R) ORAL SYRUP 2 mg/5 ml | 700988 | 549042460 | 6.9 | |||
0 | GAMAVATE(R) TOPICAL CREAM 0.05 % 25 Tube | 700895 | 550063772 | 6.6 | |||
0 | GAMMA GLOBULIN(R) INJECTION 16 % | 700896 | 7.7 |
HEPSAL(R) Intra-Venus AMPOULE 10 I.U./ml
2.7
HERCEPTIN Intra-Venus VIAL 150 MG 1
3,755.55
HIBERIX(R) Intra-Venus VIAL 10 mcg/Dose
67.35
HIBITANE OBESTET(R) TOPICAL CREAM 1%
6.85
HICONCIL(R) ORAL CAPSUL 250 mg
1.12
HICONCIL(R) ORAL CAPSUL 500 mg
2.25
HISTAFED(R) ORAL TABLET 2.5+60 mg 30 Tab
0.3
HISTALOC(R) ORAL TABLET 10 mg
0.13
HISTOL (R) ORAL SYRUP 1.25+30 mg/ml Syrups
5.65
HISTOP(R) ORAL SYRUP 2 mg/5 ml
6.9
GAMAVATE(R) TOPICAL CREAM 0.05 % 25 Tube
6.6
GAMMA GLOBULIN(R) INJECTION 16 %
7.7
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