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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
MAXIPIME(R) Intra-Venus VIAL 2 gm
701261
540014255
63.75
0
MAXITROL(R) EYE DROPS 0.35 % + 6000 unit + 0.1% 5
701262
550013071
16.3
Bottle
0
MAXITROL(R) EYE OINTMENT 0.35 % + 6000 unit + 0.1%
701263
550013072
11.3
4 Tube
0
MEASLES VACCINE LIVE ATTENUATED Intra-muscular INJECTION 0.5 ML SINGLE DOSE Box
701264
542014203
44.95
0
MEDEMYCIN(R) ORAL CAPSUL 200 mg
701265
1.58
0
MEDROL(R) ORAL TABLET 4 mg
701266
0.65
0
MEFOXIN(R) Intra-Venus VIAL 100 mg/ml
701267
30.05
0
MEFOXIN(R) Intra-Venus VIAL 2 gm
701268
30.05
0
LEUKERAN(R) ORAL TABLET 2 mg 25 Box
701175
541011010
4.34
0
LEVOPHED(R) Intra-Venus AMPOULE 1-2 mg/ml (2-4 ml)
701176
544094650
96.4
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