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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | DOLOMOL(R) RECTAL SUPPOSITORY 325 mg | 700648 | 545023115 | 0.41 | |||
0 | DOLOMOL(R) RECTAL SUPPOSITORY 650 mg | 700649 | 545023115 | 0.55 | |||
0 | DOPAMET(R) ORAL TABLET 250 mg | 700650 | 544101700 | 0.88 | |||
0 | DOPAMIN HCL(R) Intra-Venus INFUSION 400 mg/250 | 700651 | 33.7 | ||||
D5W ml Bag | |||||||
0 | DOPAMIN HCL(R) Intra-Venus INFUSION 800 mg/250 | 700652 | 544094612 | 33.7 | |||
D5W ml Bag | |||||||
0 | DOPAMIN HCL(R) Intra-Venus VIAL 40 mg/ml (200 mg/5ml) | 700653 | 544094610 | 33.7 | |||
0 | DOPAMINE FRESENIUS Intra-Venus AMPOULE 200 MG/5 ML | 700654 | 33.7 | ||||
0 | DOPANORE(R) ORAL TABLET 250 mg | 700655 | 544101700 | 0.17 | |||
0 | DORMICUM(R) Intra-Venus AMPOULE 5 mg/ml | 700656 | 545034625 | 4.33 | |||
0 | DORYX(R) ORAL CAPSUL 100 mg | 700657 | 540011320 | 2.59 |
DOLOMOL(R) RECTAL SUPPOSITORY 325 mg
0.41
DOLOMOL(R) RECTAL SUPPOSITORY 650 mg
0.55
DOPAMET(R) ORAL TABLET 250 mg
0.88
DOPAMIN HCL(R) Intra-Venus INFUSION 400 mg/250
33.7
D5W ml Bag
DOPAMIN HCL(R) Intra-Venus INFUSION 800 mg/250
33.7
D5W ml Bag
DOPAMIN HCL(R) Intra-Venus VIAL 40 mg/ml (200 mg/5ml)
33.7
DOPAMINE FRESENIUS Intra-Venus AMPOULE 200 MG/5 ML
33.7
DOPANORE(R) ORAL TABLET 250 mg
0.17
DORMICUM(R) Intra-Venus AMPOULE 5 mg/ml
4.33
DORYX(R) ORAL CAPSUL 100 mg
2.59
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