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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
DOABETIC(R) ORAL TABLET 5 mg
700637
547061620
0.62
0
DOABETIC(R) ORAL TABLET 50 mg
700638
0.69
0
DOBUTAMINE HCL(R) Intra-Venus INFUSION 500 mg /
700639
544094605
31.55
250 ml D5W 5%premix Injection
0
DOBUTAMINE HCL(R) Intra-Venus VIAL 250 mg
700640
544094600
31.55
0
DOGMATIL FORT(R) ORAL TABLET 200 mg 12 Box
700641
545031385
1.88
0
DOGMATIL(R) ORAL TABLET 50 mg 30 Tab
700642
545031531
0.71
0
DOLGIT(R) TOPICAL CREAM 50 mg/g
700643
12.25
0
DOLOMOL(R) CHEWABLE SUSPENSION 120 mg/5ml
700644
0.39
0
DOLOMOL(R) ORAL DROPS 100 mg/ml
700645
545022110
3.15
0
DOLOMOL(R) ORAL TABLET 500 mg
700646
545021100
0.05
0
DOLOMOL(R) RECTAL SUPPOSITORY 120 mg
700647
545023115
0.39
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