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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
ACICARE(R) ORAL TABLET 75 mg
700008
2.16
0
ACIDAL(R) CHEWABLE TABLET 400 mg
700009
0.22
0
ACIVIR(R) COATED ORAL TABLET 800 mg Box
700010
550063708
4.76
0
ACLASTA Intra-Venus INFUSION 5 MG ( ACLASTA ) 1 Vial
700011
547081813
2,033.55
0
ACNEZOYL(R) TOPICAL GEL 2.5%
700012
550063620
4.1
0
ACNEZOYL(R) TOPICAL GEL 5%
700013
550063620
6.55
0
ACRETIN(R) TOPICAL CREAM 0.05 30 Creams
700014
550063610
17.65
0
ACT-HIB(R) Intra-Venus VIAL
700015
542014105
76.7
0
ACTIFED EXPECTORANT(R) ORAL CAPSUL 1 100 Bottle
700016
0.32
0
ACTIFED(R) ORAL SYRUP 00 100 Bottle
700017
6.7
0
ACTIFED(R) ORAL TABLET 2.5 mg
700018
0.32
0
ACTILYSE Intra-Venus Injection 50 mg / Vial 1
700019
543063182
1,615.18
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