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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | PLENDIL(R) ORAL TABLET 10 mg | 701621 | 2.28 | ||||
0 | PMS-PYRAZINAMIDE ORAL TABLET 500 mg scored Tab | 701622 | 540041700 | 0.67 | |||
0 | PNEUMO 23(R) Intra-muscular INJECTION 25 mcg/0.5ml Box | 701623 | 542014030 | 62.75 | |||
0 | POLY VALENT SNAKE ANTI VENOM Intra-Venus | 701624 | 542034420 | 290.24 | |||
INJECTION 10ml Ampule | |||||||
0 | POLYBION(R) Intra-Venus AMPOULE 2 ml | 701625 | 4.55 | ||||
0 | POLYBION(R) ORAL DROPS % | 701626 | 12.4 | ||||
0 | POLYBION(R) ORAL TABLET 500 mg | 701627 | 548011290 | 0.71 | |||
0 | POLYMYXIN B + HYDROCORTISONE EAR DROPS 10000 | 701628 | 550028520 | 20.9 | |||
units+0.5% 5 Box | |||||||
0 | POLYMYXIN B/ BACITRACIN OPHTHALMIC OINTMENT | 701629 | 550013075 | 11.3 | |||
10000 units 4 Tube |
PLENDIL(R) ORAL TABLET 10 mg
2.28
PMS-PYRAZINAMIDE ORAL TABLET 500 mg scored Tab
0.67
PNEUMO 23(R) Intra-muscular INJECTION 25 mcg/0.5ml Box
62.75
POLY VALENT SNAKE ANTI VENOM Intra-Venus
290.24
INJECTION 10ml Ampule
POLYBION(R) Intra-Venus AMPOULE 2 ml
4.55
POLYBION(R) ORAL DROPS %
12.4
POLYBION(R) ORAL TABLET 500 mg
0.71
POLYMYXIN B + HYDROCORTISONE EAR DROPS 10000
20.9
units+0.5% 5 Box
POLYMYXIN B/ BACITRACIN OPHTHALMIC OINTMENT
11.3
10000 units 4 Tube
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