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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
BACTRIM(R) ORAL SUSPENSION
700210
19
0
BACTRIM(R) ORAL SYRUP 240 mg
700211
540072840
19
0
BACTRIM(R) ORAL TABLET 960 mg
700212
2.33
0
BACTRIM(R) Intra-Venus AMPOULE
700213
7.69
0
BACTRIM(R) ORAL SYRUP 240 mg Syrups
700214
19
0
BACTROBAN NASAL(R) Nasal Ointment 2 % 3 ?????
700215
550038565
27.7
0
BALAD Local OINTMENT 2 %
700216
9.1
0
BALAD(R) TOPICAL CREAM 2%
700217
10.8
0
BALAD(R) TOPICAL OINTMENT 2%
700218
550063720
9.1
0
BALKACYCLINE(R) ORAL CAPSUL 250 mg
700219
540011300
0.3
0
BALKAPROFEN(R) ORAL CAPSUL 200 mg
700220
0.3
0
BALKAPROFEN(R) ORAL CAPSUL 400 mg
700221
0.3
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