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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | HUMATROPE(R) Intra-Venus VIAL | 700994 | 130.2 | ||||
0 | HUMIRA Subcutaneous Syringe 40 mg / 0.8 ml 2 | 700995 | 546081706 | 2,879.95 | |||
0 | HUMULIN 70/30(R) Intra-Venus VIAL | 700996 | 547064590 | 53.55 | |||
0 | HUMULIN 70/30(R) Intra-Venus VIAL 100 I.U./ml | 700997 | 53.55 | ||||
0 | Humulin N SC INJECTION 100 / ml | 700998 | 18.74 | ||||
0 | Humulin R IV/SC INJECTION 100 u / ml | 700999 | 53.55 | ||||
0 | Humulin R SC INJECTION 100 u / ml Injection | 701000 | 18.74 | ||||
0 | HUMULIN U ULTRALENTE(R) Intra-Venus VIAL 100 I.U./ml | 701001 | 18.74 | ||||
0 | HUMULIN-L LENTE(R) Intra-Venus VIAL 100 I.U./ml | 701002 | 53.55 | ||||
0 | HUMULIN-N-NPH(R) Intra-Venus VIAL | 701003 | 547064590 | 53.55 | |||
0 | HUMULIN-R-REGULAR(R) Intra-Venus VIAL 10 ml 100 | 701004 | 547064580 | 18.74 | |||
U/ml |
HUMATROPE(R) Intra-Venus VIAL
130.2
HUMIRA Subcutaneous Syringe 40 mg / 0.8 ml 2
2,879.95
HUMULIN 70/30(R) Intra-Venus VIAL
53.55
HUMULIN 70/30(R) Intra-Venus VIAL 100 I.U./ml
53.55
Humulin N SC INJECTION 100 / ml
18.74
Humulin R IV/SC INJECTION 100 u / ml
53.55
Humulin R SC INJECTION 100 u / ml Injection
18.74
HUMULIN U ULTRALENTE(R) Intra-Venus VIAL 100 I.U./ml
18.74
HUMULIN-L LENTE(R) Intra-Venus VIAL 100 I.U./ml
53.55
HUMULIN-N-NPH(R) Intra-Venus VIAL
53.55
HUMULIN-R-REGULAR(R) Intra-Venus VIAL 10 ml 100
18.74
U/ml
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