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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | BLEOCIN(R) Intra-Venus VIAL 15 Unit | 700272 | 541044340 | 97 | |||
0 | BOTOX(R) Intra-muscular INJECTION 100 International-Unit | 700273 | 545032625 | 938.2 | |||
0 | BRAQUINOL(R) TOPICAL CREAM 5% | 700274 | 550063800 | 15.1 | |||
0 | BRICANYL(R) Intra-Venus AMPOULE 0.5 mg/ml | 700275 | 2.06 | ||||
0 | ATTENUVAX(R) Intra-Venus VIAL | 700181 | 23 | ||||
0 | AUGMENTIN Intra-Venus INJECTION 600 mg Ampule | 700182 | 540014178 | 10.18 | |||
0 | AUGMENTIN Oral Tablet 625 mg 20 | 700183 | 540011160 | 3.99 | |||
0 | AUGMENTIN(R) ORAL SUSPENSION 156 mg/5ml 100 | 700184 | 21.7 | ||||
Bottle | |||||||
0 | AUGMENTIN(R) ORAL SUSPENSION 457 mg/5ml 70 Bottle | 700185 | 41.3 | ||||
0 | AUGMENTIN(R) ORAL SYRUP 156 mg/5ml 100 Bottle | 700186 | 21.7 | ||||
0 | AUGMENTIN(R) Intra-Venus VIAL | 700187 | 540014178 | 20.36 |
BLEOCIN(R) Intra-Venus VIAL 15 Unit
97
BOTOX(R) Intra-muscular INJECTION 100 International-Unit
938.2
BRAQUINOL(R) TOPICAL CREAM 5%
15.1
BRICANYL(R) Intra-Venus AMPOULE 0.5 mg/ml
2.06
ATTENUVAX(R) Intra-Venus VIAL
23
AUGMENTIN Intra-Venus INJECTION 600 mg Ampule
10.18
AUGMENTIN Oral Tablet 625 mg 20
3.99
AUGMENTIN(R) ORAL SUSPENSION 156 mg/5ml 100
21.7
Bottle
AUGMENTIN(R) ORAL SUSPENSION 457 mg/5ml 70 Bottle
41.3
AUGMENTIN(R) ORAL SYRUP 156 mg/5ml 100 Bottle
21.7
AUGMENTIN(R) Intra-Venus VIAL
20.36
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