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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
DAKTARIN(R) TOPICAL OINTMENT 2%
700527
550063730
21.45
0
DAKTARIN(R) TOPICAL POWDER 2%
700528
15.1
0
DALACIN C(R) Intra-Venus Injection 300 mg/2ml 1 Ampule
700529
540014380
17.7
0
DANOL(R) ORAL CAPSUL 100 mg 100 Capsule
700530
547011170
2.31
0
Darunavir ORAL TABLET 300mg
700531
40051753
15.71
0
Darunavir ORAL TABLET 400mg
700532
540051755
15.71
0
Darunavir ORAL TABLET 600mg
700533
40051755
15.71
0
DBL ACYCLOVIR(R) Intra-Venus VIAL 250 mg/10ml Vial
700534
540054770
42.47
0
DBL ACYCLOVIR(R) Intra-Venus VIAL 500 mg/20ml
700535
540054760
83.56
0
DBL CYTARABINE(R) Intra-Venus VIAL 20mg/ml
700536
541024142
16.15
0
DECADRON NEO(R) Intra-Venus INJECTION 4 mg/2ml
700537
5.4
0
DECADRON NEO(R) TOPICAL CREAM 0.1%
700538
10.25
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