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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | ISOPRENALINE Intra-Venus INJECTION 200 mcg/ml | 701074 | 544094640 | 22.65 | |||
0 | ISOPROTERENOL HCL(R) SYRINGE 1:5000 | 701075 | 22.65 | ||||
0 | ISOPTIN RETARD(R) ORAL TABLET 120 mg | 701076 | 1.19 | ||||
0 | ISOPTIN SR(R) Intra-Venus AMPOULE 2.5 mg/ml | 701077 | 544034130 | 3.35 | |||
0 | ISOPTIN SR(R) ORAL TABLET 240 mg | 701078 | 2.1 | ||||
0 | ISOPTIN(R) ORAL TABLET 40 mg Tab | 701079 | 544031120 | 0.43 | |||
0 | HOLOXAN(R) Intra-Venus VIAL 1 gm | 700989 | 541014062 | 141.4 | |||
0 | HUMALOG MIX 25 SUBCUTANEOUS INJECTION 25 % + 75 % | 700990 | 547064602 | 33.72 | |||
0 | HUMALOG MIX 50 SUBCUTANEOUS INJECTION 50 % + | 700991 | 547064601 | 33.72 | |||
50% | |||||||
0 | HUMALOG(R) SUBCUTANEOUS INJECTION 100 / 10 ML | 700992 | 547064595 | 93.75 | |||
0 | HUMAN NORMAL IMMUNOGLOBULIN Intra-Venus INJECTION 2.5 gm / 50 ml | 700993 | 691.95 |
ISOPRENALINE Intra-Venus INJECTION 200 mcg/ml
22.65
ISOPROTERENOL HCL(R) SYRINGE 1:5000
22.65
ISOPTIN RETARD(R) ORAL TABLET 120 mg
1.19
ISOPTIN SR(R) Intra-Venus AMPOULE 2.5 mg/ml
3.35
ISOPTIN SR(R) ORAL TABLET 240 mg
2.1
ISOPTIN(R) ORAL TABLET 40 mg Tab
0.43
HOLOXAN(R) Intra-Venus VIAL 1 gm
141.4
HUMALOG MIX 25 SUBCUTANEOUS INJECTION 25 % + 75 %
33.72
HUMALOG MIX 50 SUBCUTANEOUS INJECTION 50 % +
33.72
50%
HUMALOG(R) SUBCUTANEOUS INJECTION 100 / 10 ML
93.75
HUMAN NORMAL IMMUNOGLOBULIN Intra-Venus INJECTION 2.5 gm / 50 ml
691.95
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