Prescription Drug - Brand Procedure Costs — 3320 Procedures

00135009626

GAVISCON 80-14.2 MG TAB CHEW

Prescription Drug - Brand

$0

—

00135018301

TUMS ULTRA TABLET CHEWABLE

Prescription Drug - Brand

$0

—

00135019402

NICODERM CQ 21 MG/24HR PATCH

Prescription Drug - Brand

$3

—

00135019503

NICODERM CQ 14 MG/24HR PATCH

Prescription Drug - Brand

$3

—

00135019605

NICODERM CQ 7 MG/24HR PATCH

Prescription Drug - Brand

$3

—

00135019902

CITRUCEL 500 MG CAPLET

Prescription Drug - Brand

$0

—

00135020005

ABREVA 10% CREAM

Prescription Drug - Brand

$8

—

00135024105

NICORETTE 2 MG CHEWING GUM

Prescription Drug - Brand

$0

—

00135024208

NICORETTE 4 MG CHEWING GUM

Prescription Drug - Brand

$0

—

00135043003

GAVISCON ES TABLET CHEW

Prescription Drug - Brand

$0

—

00135045603

TUMS SMOOTHIES CHEW TABLET

Prescription Drug - Brand

$0

—

00135046105

ALLI 60 MG CAPSULE

Prescription Drug - Brand

$0

—

00135046901

TUMS KIDS 300 MG (750) CHEWTAB

Prescription Drug - Brand

$0

—

00135050804

NICORETTE 2 MG MINI LOZENGE

Prescription Drug - Brand

$0

—

00135050902

NICORETTE 4 MG MINI LOZENGE

Prescription Drug - Brand

$0

—

00135051403

NICORETTE 2 MG LOZENGE

Prescription Drug - Brand

$0

—

00135051503

NICORETTE 4 MG LOZENGE

Prescription Drug - Brand

$0

—

00135052202

TUMS FRESHERS ANTACID CHEW TAB

Prescription Drug - Brand

$0

—

00135056001

TUMS ULTRA STR CHEWY DELIGHTS

Prescription Drug - Brand

$0

—

00135057401

GAVISCON EXTRA STRENGTH LIQUID

Prescription Drug - Brand

$0

—

00135057603

FLONASE ALLERGY RLF 50 MCG SPR

Prescription Drug - Brand

$1

—

00135058201

CHILD FLONASE ALLER RLF 50 MCG

Prescription Drug - Brand

$1

—

00135060602

TUMS 750 MG CHEWY BITES

Prescription Drug - Brand

$0

—

00135061101

TUMS TABLET CHEWABLE

Prescription Drug - Brand

$0

—

00135061503

FLONASE SENSIMIST 27.5 MCG SPR

Prescription Drug - Brand

$2

—

00135061601

CHLD FLONASE SENSIMIST 27.5 MCG

Prescription Drug - Brand

$2

—

00145007130

VELTIN GEL

Prescription Drug - Brand

$11

—

00145009025

SORIATANE 10 MG CAPSULE

Prescription Drug - Brand

$43

—

00145009125

SORIATANE 25 MG CAPSULE

Prescription Drug - Brand

$52

—

00145062805

SARNA ORIGINAL 0.5%-0.5% LOTN

Prescription Drug - Brand

$0

—

00145098305

PANOXYL 10% ACNE CLEANSING BAR

Prescription Drug - Brand

$4

—

00145098505

PANOXYL 10% ACNE FOAMING WASH

Prescription Drug - Brand

$0

—

00145237105

DUAC 1.2-5% GEL

Prescription Drug - Brand

$7

—

00145266005

PANOXYL-4 ACNE CREAMY WASH

Prescription Drug - Brand

$0

—

00169008181

PRANDIN 0.5 MG TABLET

Prescription Drug - Brand

$6

—

00169008281

PRANDIN 1 MG TABLET

Prescription Drug - Brand

$6

—

00169008481

PRANDIN 2 MG TABLET

Prescription Drug - Brand

$6

—

00169183302

RELION NOVOLIN R 100 UNIT/ML

Prescription Drug - Brand

$13

—

00169183311

NOVOLIN R 100 UNITS/ML VIAL

Prescription Drug - Brand

$13

—

00169183402

RELION NOVOLIN N 100 UNIT/ML

Prescription Drug - Brand

$13

—

00169183411

NOVOLIN N 100 UNITS/ML VIAL

Prescription Drug - Brand

$13

—

00169183702

RELION NOVOLIN 70-30 VIAL

Prescription Drug - Brand

$13

—

00169183711

NOVOLIN 70-30 100 UNIT/ML VIAL

Prescription Drug - Brand

$5

—

00169191201

ZEGALOGUE 0.6 MG/0.6 ML AUTOINJ

Prescription Drug - Brand

$494

—

00169191302

ZEGALOGUE 0.6 MG/0.6 ML SYRING

Prescription Drug - Brand

$495

—

00169255013

TRESIBA FLEXTOUCH 200 UNITS/ML

Prescription Drug - Brand

$65

—

00169266015

TRESIBA FLEXTOUCH 100 UNITS/ML

Prescription Drug - Brand

$33

—

00169266211

TRESIBA 100 UNIT/ML VIAL

Prescription Drug - Brand

$9

—

00169280015

SAXENDA 18 MG/3 ML PEN

Prescription Drug - Brand

$87

—

00169291115

XULTOPHY 100 UNIT-3.6 MG/ML PEN

Prescription Drug - Brand

$86

—

Prescription Drug - Brand Procedures

My Cost List