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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
short acting ) 1 Ampule | |||||||
0 | SYNAGIS Intra-muscular INJECTION 100 MG 1 Injection | 702020 | 540051769 | 3,680.15 | |||
0 | SYNTOCINON(R) Intra-Venus AMPOULE 5 International- Unit/ml | 702021 | 547034250 | 2.33 | |||
0 | SYSTANE EYE DROPS 0.4 % + 0.3 % Bottle | 702022 | 550013464 | 31.05 | |||
0 | TABETA(R) SCAlP LOTION 0.1% 15 Tube | 702023 | 550063770 | 10.9 | |||
0 | TABICLOR(R) Oral Suspension 375 mg/5ml 75 ?????? | 702024 | 32.3 | ||||
0 | TABIFLEX COOL(R) TOPICAL GEL 1% | 702025 | 7.85 | ||||
0 | TABIFLEX RETARD(R) ORAL TABLET 100 mg | 702026 | 2.14 | ||||
0 | TABIGESIC FORTE(R) ORAL TABLET 500 mg | 702027 | 0.41 | ||||
0 | TABIGESIC(R) CHEWABLE SUSPENSION 50 mg/5ml | 702028 | 11.35 | ||||
0 | TABIGESIC(R) ORAL TABLET 250 mg | 702029 | 0.2 | ||||
0 | TABOCIN(R) ORAL CAPSUL 100 mg | 702030 | 540011320 | 2.89 |
short acting ) 1 Ampule
SYNAGIS Intra-muscular INJECTION 100 MG 1 Injection
3,680.15
SYNTOCINON(R) Intra-Venus AMPOULE 5 International- Unit/ml
2.33
SYSTANE EYE DROPS 0.4 % + 0.3 % Bottle
31.05
TABETA(R) SCAlP LOTION 0.1% 15 Tube
10.9
TABICLOR(R) Oral Suspension 375 mg/5ml 75 ??????
32.3
TABIFLEX COOL(R) TOPICAL GEL 1%
7.85
TABIFLEX RETARD(R) ORAL TABLET 100 mg
2.14
TABIGESIC FORTE(R) ORAL TABLET 500 mg
0.41
TABIGESIC(R) CHEWABLE SUSPENSION 50 mg/5ml
11.35
TABIGESIC(R) ORAL TABLET 250 mg
0.2
TABOCIN(R) ORAL CAPSUL 100 mg
2.89
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