Prescription Drug - Brand Procedure Costs — 3320 Procedures

00173056510

VALTREX 1 GRAM CAPLET

Prescription Drug - Brand

$20

—

00173059402

LAMICTAL TB START KIT (ORANGE)

Prescription Drug - Brand

$11

—

00173060002

FLOVENT 50 MCG DISKUS

Prescription Drug - Brand

$3

—

00173060102

FLOVENT 250 MCG DISKUS

Prescription Drug - Brand

$4

—

00173060202

FLOVENT 100 MCG DISKUS

Prescription Drug - Brand

$3

—

00173063302

LAMICTAL 25 MG TABLET

Prescription Drug - Brand

$10

—

00173064255

LAMICTAL 100 MG TABLET

Prescription Drug - Brand

$11

—

00173064360

LAMICTAL 150 MG TABLET

Prescription Drug - Brand

$11

—

00173064460

LAMICTAL 200 MG TABLET

Prescription Drug - Brand

$12

—

00173066200

EPIVIR HBV 100 MG TABLET

Prescription Drug - Brand

$14

—

00173066518

MEPRON 750 MG/5 ML SUSPENSION

Prescription Drug - Brand

$7

—

00173067502

MALARONE 250-100 MG TABLET

Prescription Drug - Brand

$7

—

00173068101

RELENZA 5 MG DISKHALER

Prescription Drug - Brand

$3

—

00173068224

VENTOLIN HFA 90 MCG INHALER

Prescription Drug - Brand

$3

—

00173069500

ADVAIR 100-50 DISKUS

Prescription Drug - Brand

$2

—

00173069600

ADVAIR 250-50 DISKUS

Prescription Drug - Brand

$3

—

00173069700

ADVAIR 500-50 DISKUS

Prescription Drug - Brand

$4

—

00173071522

ADVAIR HFA 45-21 MCG INHALER

Prescription Drug - Brand

$20

—

00173071620

ADVAIR HFA 115-21 MCG INHALER

Prescription Drug - Brand

$25

—

00173071720

ADVAIR HFA 230-21 MCG INHALER

Prescription Drug - Brand

$35

—

00173071820

FLOVENT HFA 44 MCG INHALER

Prescription Drug - Brand

$18

—

00173071920

FLOVENT HFA 110 MCG INHALER

Prescription Drug - Brand

$22

—

00173072020

FLOVENT HFA 220 MCG INHALER

Prescription Drug - Brand

$34

—

00173072200

WELLBUTRIN SR 200 MG TABLET

Prescription Drug - Brand

$14

—

00173073601

IMITREX 50 MG TABLET

Prescription Drug - Brand

$73

—

00173073701

IMITREX 100 MG TABLET

Prescription Drug - Brand

$72

—

00173074000

CEFTIN 125 MG/5 ML ORAL SUSP

Prescription Drug - Brand

$1

—

00173074110

CEFTIN 250 MG/5 ML ORAL SUSP

Prescription Drug - Brand

$2

—

00173075300

VERAMYST 27.5 MCG NASAL SPRAY

Prescription Drug - Brand

$18

—

00173075400

LAMICTAL XR 25 MG TABLET

Prescription Drug - Brand

$14

—

00173075500

LAMICTAL XR 50 MG TABLET

Prescription Drug - Brand

$28

—

00173075600

LAMICTAL XR 100 MG TABLET

Prescription Drug - Brand

$30

—

00173075700

LAMICTAL XR 200 MG TABLET

Prescription Drug - Brand

$32

—

00173076100

LAMICTAL XR 300 MG TABLET

Prescription Drug - Brand

$49

—

00173077202

LAMICTAL ODT 25 MG TABLET

Prescription Drug - Brand

$13

—

00173077402

LAMICTAL ODT 50 MG TABLET

Prescription Drug - Brand

$14

—

00173077602

LAMICTAL ODT 100 MG TABLET

Prescription Drug - Brand

$15

—

00173077702

LAMICTAL ODT 200 MG TABLET

Prescription Drug - Brand

$17

—

00173077800

LAMICTAL ODT START KT (ORANGE)

Prescription Drug - Brand

$12

—

00173078100

LAMICTAL XR 250 MG TABLET

Prescription Drug - Brand

$44

—

00173080959

JALYN 0.5-0.4 MG CAPSULE

Prescription Drug - Brand

$22

—

00173081059

POTIGA 50 MG TABLET

Prescription Drug - Brand

$6

—

00173081259

POTIGA 200 MG TABLET

Prescription Drug - Brand

$12

—

00173082204

STAXYN 10 MG ODT

Prescription Drug - Brand

$31

—

00173082318

RYTHMOL SR 225 MG CAPSULE

Prescription Drug - Brand

$12

—

00173082418

RYTHMOL SR 325 MG CAPSULE

Prescription Drug - Brand

$15

—

00173082913

LEVITRA 5 MG TABLET

Prescription Drug - Brand

$51

—

00173083013

LEVITRA 10 MG TABLET

Prescription Drug - Brand

$49

—

00173083113

LEVITRA 20 MG TABLET

Prescription Drug - Brand

$50

—

00173085914

BREO ELLIPTA 100-25 MCG INHALR

Prescription Drug - Brand

$5

—

Prescription Drug - Brand Procedures

My Cost List