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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
DEXTROSE(R) Intra-Venus INJECTION 50 ml Injection
700574
548034600
4.55
0
DEXTROSE(R) Intra-Venus PLASTIC BAG 500 ml
700575
548034550
5
0
DEXTROSE(R) Intra-Venus PIGI BAG 100 ml
700576
548034547
4.55
0
DIA(R) ORAL TABLET 5 mg
700577
547061620
0.26
0
DIALON FC(R) ORAL TABLET 500 mg
700578
547061640
0.33
0
DIAMICRON MR ORAL TABLET 60 mg ( MR ) Box
700579
547061607
0.85
0
DIAMICRON MR(R) ORAL TABLET 30 mg
700580
547061602
0.85
0
DIAMICRON(R) ORAL TABLET 80 mg
700581
547061600
0.57
0
DIAMOX(R) Intra-Venus VIAL 500 mg Vial
700582
550014370
16.3
0
DIAPHAGE(R) ORAL TABLET 500 mg
700583
547061640
0.33
0
DIATAB(R) ORAL TABLET 5 mg
700584
0.69
0
DIAZEPAM(R) Oral Tablet 2 mg 30 Tab
700585
545031360
0.18
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