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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
DOLOMOL(R) RECTAL SUPPOSITORY 325 mg
700648
545023115
0.41
0
DOLOMOL(R) RECTAL SUPPOSITORY 650 mg
700649
545023115
0.55
0
DOPAMET(R) ORAL TABLET 250 mg
700650
544101700
0.88
0
DOPAMIN HCL(R) Intra-Venus INFUSION 400 mg/250
700651
33.7
D5W ml Bag
0
DOPAMIN HCL(R) Intra-Venus INFUSION 800 mg/250
700652
544094612
33.7
D5W ml Bag
0
DOPAMIN HCL(R) Intra-Venus VIAL 40 mg/ml (200 mg/5ml)
700653
544094610
33.7
0
DOPAMINE FRESENIUS Intra-Venus AMPOULE 200 MG/5 ML
700654
33.7
0
DOPANORE(R) ORAL TABLET 250 mg
700655
544101700
0.17
0
DORMICUM(R) Intra-Venus AMPOULE 5 mg/ml
700656
545034625
4.33
0
DORYX(R) ORAL CAPSUL 100 mg
700657
540011320
2.59
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