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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
LOCOID(R) TOPICAL OINTMENT 0.1%
701211
22.65
0
LOMIR SPRO(R) ORAL CAPSUL 5 mg
701212
2.33
0
LOMIR(R) ORAL TABLET 2.5 mg
701213
1.54
0
LOMIR(R) ORAL TABLET 400 mg
701214
1.54
0
LOPRESOR(R) ORAL TABLET 50 mg 40 Tab
701215
544051207
0.69
0
LORINE ORAL TABLET 10 mg Tab
701216
1.77
0
LOSEC(R) Intra-Venus VIAL 40 mg Vial
701217
546031238
44.35
0
LOSEC(R) ORAL CAPSUL 20 mg 14 Capsule
701218
546031236
8.54
0
LOTENSE Oral Tablet 5 mg 30 ???
701219
544031097
1.78
0
LOVRAK(R) Oral Suspension 200 mg / 5 ml
701220
540051762
110.7
0
LOVRAK(R) Topical Cream 5% 10 ?????
701221
550063700
64.6
0
LOVRAK(R) Topical Ointment 5 % 10 ?????
701222
550063700
64.6
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