Prescription Drug - Brand Procedure Costs — 3320 Procedures

00085300403

TEMODAR 5 MG CAPSULE

Prescription Drug - Brand

$17

—

00085314901

ELOCON 0.1% CREAM

Prescription Drug - Brand

$3

—

00085331035

NITRO-DUR 0.2 MG/HR PATCH

Prescription Drug - Brand

$4

—

00085432402

NOXAFIL DR 100 MG TABLET

Prescription Drug - Brand

$66

—

00085461001

DULERA 200 MCG/5 MCG INHALER

Prescription Drug - Brand

$23

—

00085720601

DULERA 100 MCG/5 MCG INHALER

Prescription Drug - Brand

$23

—

00087606010

GLUCOPHAGE 500 MG TABLET

Prescription Drug - Brand

$1

—

00087606313

GLUCOPHAGE XR 500 MG TAB

Prescription Drug - Brand

$1

—

00087607111

GLUCOPHAGE 1,000 MG TABLET

Prescription Drug - Brand

$2

—

00087607411

GLUCOVANCE 5-500 MG TABLET

Prescription Drug - Brand

$1

—

00088210224

PRIFTIN 150 MG TABLET

Prescription Drug - Brand

$5

—

00088216130

ARAVA 20 MG TABLET

Prescription Drug - Brand

$38

—

00088221905

LANTUS SOLOSTAR 100 UNITS/ML

Prescription Drug - Brand

$24

—

00088222033

LANTUS 100 UNITS/ML VIAL

Prescription Drug - Brand

$24

—

00088250033

APIDRA 100 UNITS/ML VIAL

Prescription Drug - Brand

$27

—

00088250205

APIDRA SOLOSTAR 100 UNIT/ML

Prescription Drug - Brand

$11

—

00095067416

ZOLVIT 10 MG-300 MG/15 ML SOLUTION

Prescription Drug - Brand

$0

—

00095095005

ZOLPIMIST 5 MG ORAL SPRAY

Prescription Drug - Brand

$14

—

00095702901

ORBIVAN CAPSULE

Prescription Drug - Brand

$2

—

00096073516

DHS ZINC 2% SHAMPOO

Prescription Drug - Brand

$0

—

00096073608

DHS TAR GEL 0.5% SHAMPOO

Prescription Drug - Brand

$0

—

00096073708

DHS TAR 0.5% SHAMPOO

Prescription Drug - Brand

$0

—

00096073804

DHS SAL 3% SHAMPOO

Prescription Drug - Brand

$0

—

00113172011

NASONEX 24HR ALLERGY 50 MCG NASAL SPRAY

Prescription Drug - Brand

$1

—

00113600203

PREVACID 24HR DR 15 MG CAPSULE

Prescription Drug - Brand

$1

—

00113810103

OPILL 0.075 MG TABLET

Prescription Drug - Brand

$0

—

00116106140

DYNA-HEX 4% LIQUID

Prescription Drug - Brand

$0

—

00131247760

VIMPAT 50 MG TABLET

Prescription Drug - Brand

$12

—

00131247860

VIMPAT 100 MG TABLET

Prescription Drug - Brand

$19

—

00131247960

VIMPAT 150 MG TABLET

Prescription Drug - Brand

$20

—

00131248060

VIMPAT 200 MG TABLET

Prescription Drug - Brand

$20

—

00131541072

VIMPAT 10 MG/ML SOLUTION

Prescription Drug - Brand

$2

—

00132007950

FLEET GLYCERIN 2 GM ADULT SUPP

Prescription Drug - Brand

$0

—

00132010624

FLEET PEDIA-LAX STOOL SOFTENER

Prescription Drug - Brand

$0

—

00132018582

FLEET GLYCERIN LIQUID SUPP

Prescription Drug - Brand

$0

—

00132019012

FLEET PEDIA-LAX SUPPOSITORIES

Prescription Drug - Brand

$0

—

00132020142

FLEET ENEMA

Prescription Drug - Brand

$0

—

00132020220

FLEET PEDIA-LAX ENEMA

Prescription Drug - Brand

$0

—

00132020812

PHAZYME 180 MG SOFTGEL

Prescription Drug - Brand

$0

—

00132021112

PHAZYME 250 MG SOFTGEL

Prescription Drug - Brand

$0

—

00132030140

FLEET MINERAL OIL ENEMA

Prescription Drug - Brand

$0

—

00132065501

FLEET PEDIA-LAX TABLET CHEW

Prescription Drug - Brand

$0

—

00132070336

FLEET BISACODYL 10 MG ENEMA

Prescription Drug - Brand

$0

—

00132070402

FLEET BISACODYL EC 5 MG TAB

Prescription Drug - Brand

$0

—

00135007401

TUMS X-STR 750 TABLET CHEWABLE

Prescription Drug - Brand

$0

—

00135007424

TUMS E-X TABLET CHEWABLE

Prescription Drug - Brand

$0

—

00135008969

CITRUCEL POWDER

Prescription Drug - Brand

$0

—

00135009070

CITRUCEL POWDER S-F

Prescription Drug - Brand

$0

—

00135009441

GAVISCON LIQUID

Prescription Drug - Brand

$0

—

00135009541

GAVISCON EXTRA STRENGTH LIQ

Prescription Drug - Brand

$0

—

Prescription Drug - Brand Procedures

My Cost List