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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
AMBISONE Intra-Venus INJECTION 50 MG 1 Injection
700067
540024496
444.33
0
AMFIPEN(R) Intra-Venus VIAL 250 mg
700068
540014035
3.57
0
AMFIPEN(R) Intra-Venus VIAL 500 mg
700069
540014035
3.25
0
AMICAR(R) Intra-Venus INJECTION 250 mg / ml
700070
543064401
6.9
0
AMIDRONE ORAL TABLET 200 mg
700071
544061410
1.09
0
AMIKACIN(R) Intra-Venus VIAL 500 mg/2ml Vial
700072
540014420
33.5
0
AMIKIN(R) Intra-Venus AMPOULE 100 mg/2ml
700073
540014425
20.05
0
AMIKIN(R) Intra-Venus AMPOULE 500 mg/2ml
700074
540014420
33.5
0
AMINO ACIDS (PEDIATRIC) Intra-Venus INFUSION 10%
700075
548034510
84.4
(100 mL) Vial
0
AMINOFUSIN L(R) INJECTION 10 %
700076
68.65
0
AMINOFUSIN PAED 900(R) INJECTION
700077
38.4
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