number - West Plano Emergency Room

... ALLOPURINOL 100 MG TAB. 2.66. 11/1/2016. 5440092031 ALLOPURINOL 300 MG TAB. 3.96. 11/1/2016. 5440092038 WATER STERILE 10 ML VIAL. 6.65. 11/1/ ...







Milford Hospital 01 31 2018.xls - CT.gov
NICOTINE TD DIS 14/MG/24HR. AWP+. 4215006260. NICOTINE TD DIS 21 MG/24HR. AWP+. 4215006270. NICOTINE TD DIS 7MG/24HR. AWP+. 4215006278.
CMS Mandate - Chargemaster - Advanced Specialty Hospitals
... ALLOPURINOL 100 MG TABLET. 250. 4.89. 2500402. AZAS2.50S. 250. 101.30. 2500403. TIAGABINE HCL 4 MG TABLET. 250. 10.04. 2500405. ESTRADIOL 0.05 MG. 250. 28.74.
itemnum description revcode serviceid mod1 mod2 amount units
LS CLAVE MALE ADAPT PLUG100/CS. ICU MEDICAL SALES. 04091-2568-01. 10248700. LS CLAVE PORT LUER LOCK 100/CS. ICU MEDICAL SALES. 04091-1956-01. 10248188. LS EXT ...



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Without Pharmacy January 2022 IVNUM IVDESC CPT PT Chg ...