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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
RANTAG(R) ORAL TABLET 75 mg
701730
546031230
0.91
0
RAPAMUNE COATED ORAL TABLET 1 mg
701731
551081580
19.51
0
RAPIDUS(R) ORAL TABLET 25 mg
701732
0.98
0
RAPIDUS(R) ORAL TABLET 50 mg
701733
1.87
0
RAPILELYSIN Intra-Venus INJECTION 10 UNIT / VIAL
701734
543063183
1,615.18
0
REBETOL ORAL TABLET 200 mg Tab
701735
540051778
9.83
0
REBIF(R) Intra-Venus VIAL 100 mcg
701736
541074538
397.75
0
RECOFOL(R) INJECTION 10 mg/ml
701737
60.75
0
RECOFOL(R) Intra-Venus AMPOULE
701738
21.72
0
RECORMON SUBCUTANEOUS INJECTION 10,000 I.U 1
701739
543014126
590.86
0
RECORMON SUBCUTANEOUS INJECTION 30,000 I.U 1
701740
543014127
590.86
0
RECORMON(R) Intra-Venus INJECTION 1000
701741
543014123
57.99
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