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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | RANTAG(R) ORAL TABLET 75 mg | 701730 | 546031230 | 0.91 | |||
0 | RAPAMUNE COATED ORAL TABLET 1 mg | 701731 | 551081580 | 19.51 | |||
0 | RAPIDUS(R) ORAL TABLET 25 mg | 701732 | 0.98 | ||||
0 | RAPIDUS(R) ORAL TABLET 50 mg | 701733 | 1.87 | ||||
0 | RAPILELYSIN Intra-Venus INJECTION 10 UNIT / VIAL | 701734 | 543063183 | 1,615.18 | |||
0 | REBETOL ORAL TABLET 200 mg Tab | 701735 | 540051778 | 9.83 | |||
0 | REBIF(R) Intra-Venus VIAL 100 mcg | 701736 | 541074538 | 397.75 | |||
0 | RECOFOL(R) INJECTION 10 mg/ml | 701737 | 60.75 | ||||
0 | RECOFOL(R) Intra-Venus AMPOULE | 701738 | 21.72 | ||||
0 | RECORMON SUBCUTANEOUS INJECTION 10,000 I.U 1 | 701739 | 543014126 | 590.86 | |||
0 | RECORMON SUBCUTANEOUS INJECTION 30,000 I.U 1 | 701740 | 543014127 | 590.86 | |||
0 | RECORMON(R) Intra-Venus INJECTION 1000 | 701741 | 543014123 | 57.99 |
RANTAG(R) ORAL TABLET 75 mg
0.91
RAPAMUNE COATED ORAL TABLET 1 mg
19.51
RAPIDUS(R) ORAL TABLET 25 mg
0.98
RAPIDUS(R) ORAL TABLET 50 mg
1.87
RAPILELYSIN Intra-Venus INJECTION 10 UNIT / VIAL
1,615.18
REBETOL ORAL TABLET 200 mg Tab
9.83
REBIF(R) Intra-Venus VIAL 100 mcg
397.75
RECOFOL(R) INJECTION 10 mg/ml
60.75
RECOFOL(R) Intra-Venus AMPOULE
21.72
RECORMON SUBCUTANEOUS INJECTION 10,000 I.U 1
590.86
RECORMON SUBCUTANEOUS INJECTION 30,000 I.U 1
590.86
RECORMON(R) Intra-Venus INJECTION 1000
57.99
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