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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
PROSCAR(R) ORAL TABLET 5 mg
701694
547011025
4.28
0
PROSTAPHLIN-A(R) Intra-Venus VIAL 250mg/vial
701695
540011110
5.74
0
PROSTIN E(R) VAGINAL TABLET 3 mg 4 Box
701696
547015190
54.5
0
PROSTIN E2(R) Intra-Venus AMPOULE 10 mg/ml
701697
547014180
112.6
0
PROSTIN VR(R) Intra-Venus Ampoule 0.5 mg / ml
701698
551104570
112.6
0
PROTAMINE SULPHATE(R) Intra-Venus AMPOULE 10
701699
543034240
3.15
mg/ml 5ML/AMP Ampule
0
PROTIGUMIN Intra-Venus INJECTION 0.5 mg/ml
701700
545064860
1.86
0
PROTOPIC TOPICAL OINTMENT 0.03 % Tube
701701
551081590
195.4
0
PROTOPIC TOPICAL OINTMENT 0.1 %
701702
551081595
228.05
0
PROVERA(R) ORAL TABLET 5 mg 24 Tab
701703
547011015
0.72
0
PROVISC(R) EYE DROPS 0.2 % 1 Bottle
701704
550014462
33.9
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