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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
PROFINAL(R) ORAL TABLET 200 mg
701683
545021200
0.35
0
PROFINAL(R) ORAL TABLET 400 mg
701684
545021200
0.5
0
PROFINAL(R) ORAL TABLET 600 mg
701685
545021200
0.54
0
PROFINAL(R) TOPICAL GEL 5%
701686
5.8
0
PROGESTERONE Intra-muscular INJECTION 250 mg/ml
701687
547014051
20.45
0
PROGRAF(R) ORAL CAPSUL 0.5 mg Box
701688
551081550
10.8
0
PROGRAF(R) ORAL CAPSUL 1 mg 100 Box
701689
551081560
10.8
0
PROGRAF(R) ORAL CAPSUL 5 mg Box
701690
551081570
47.98
0
PROLIA SUBCUTANEOUS INJECTION 60 MG/ ML
701691
547011176
1,081.35
0
PROPOFOL(R) Intra-Venus AMPOULE 200 mg/amp
701692
545044658
68.35
Ampule
0
PROPYLTHIOURACIL(R) ORAL TABLET 50 mg 100 Tab
701693
547071750
0.15
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