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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
short acting ) 1 Ampule
0
SYNAGIS Intra-muscular INJECTION 100 MG 1 Injection
702020
540051769
3,680.15
0
SYNTOCINON(R) Intra-Venus AMPOULE 5 International- Unit/ml
702021
547034250
2.33
0
SYSTANE EYE DROPS 0.4 % + 0.3 % Bottle
702022
550013464
31.05
0
TABETA(R) SCAlP LOTION 0.1% 15 Tube
702023
550063770
10.9
0
TABICLOR(R) Oral Suspension 375 mg/5ml 75 ??????
702024
32.3
0
TABIFLEX COOL(R) TOPICAL GEL 1%
702025
7.85
0
TABIFLEX RETARD(R) ORAL TABLET 100 mg
702026
2.14
0
TABIGESIC FORTE(R) ORAL TABLET 500 mg
702027
0.41
0
TABIGESIC(R) CHEWABLE SUSPENSION 50 mg/5ml
702028
11.35
0
TABIGESIC(R) ORAL TABLET 250 mg
702029
0.2
0
TABOCIN(R) ORAL CAPSUL 100 mg
702030
540011320
2.89
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