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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
ULTRASPORIN(R) CHEWABLE SUSPENSION 125 mg/5ml
702157
11.3
0
ULTRASPORIN(R) ORAL CAPSUL 250 mg
702158
540011200
0.85
0
ULTRATARD HM(R) Intra-Venus VIAL 100 I.U.
702159
53.55
0
UNICROM(R) EYE DROPS 2%
702160
10.6
0
UNIVIT-A FORT(R) ORAL CAPSUL 50,000
702161
548011001
0.29
International\Unit ????
0
UPSA-C EFFER GM(R) ORAL TABLET 1 gm
702162
0.58
0
URBASON(R) ORAL TABLET 4 mg
702163
0.65
0
URDOX Oral Capsule 250 mg Capsule
702164
546012000
2.82
0
UROGRAFIN 76% Intra-Venus INJECTION 370-400 MG/50
702165
551154760
428.09
ML Injection
0
UROMITEXAN(R) Intra-Venus AMPOULE 400 mg
702166
541014064
5.48
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