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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
LIPOFUNDIN-S(R) Intra-Venus VIAL 20% Vial
701199
548034650
45.35
0
LIPOMAX Oral Tablet 20 MG 10 Tablet
701200
544121906
4.92
0
LIPOSTAT(R) ORAL TABLET 40 mg 30 Tab
701201
544121902
3.46
0
LISKONUM(R) ORAL TABLET 400 mg 1000 Box
701202
545031630
0.16
0
LITAREX(R) ORAL TABLET 564 mg
701203
0.16
0
LITHIOFOR(R) ORAL TABLET 660 mg
701204
0.86
0
LOCAGEL(R) TOPICAL GEL 1%
701205
4.4
0
LOCERYL NAIL LACQUER Local Solution 5 % ( Only for Nail Use ) 5
701206
540021496
144.05
0
LOCOID CRELO(R) TOPICAL CREAM 0.1%
701207
22.65
0
LOCOID LIPO(R) TOPICAL CREAM 0.1%
701208
22.65
0
LOCOID(R) TOPICAL CREAM 0.1%
701209
550063748
22.65
0
LOCOID(R) TOPICAL LOTION 0.1%
701210
22.65
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