Prescription Drug - Brand Procedure Costs — 3320 Procedures

15370025030

TRISTART DHA SOFTGEL

Prescription Drug - Brand

$9

—

15370030560

POKONZA 10 MEQ PACKET

Prescription Drug - Brand

$28

—

15584010101

ATRIPLA TABLET

Prescription Drug - Brand

$97

—

15821010115

FRESHKOTE EYE DROPS

Prescription Drug - Brand

$2

—

15821050190

TOZAL SOFTGEL

Prescription Drug - Brand

$0

—

16477012030

DALLERGY DROPS

Prescription Drug - Brand

$1

—

16571072360

SULFAMYLON 8.5% CREAM

Prescription Drug - Brand

$1

—

16781046275

CLINDAGEL 1% GEL

Prescription Drug - Brand

$22

—

169413602

OZEMPIC 1 MG/DOSE (2 MG/1.5 ML) PEN

Prescription Drug - Brand

$285

—

17350001505

RESCULA 0.15% EYE DROPS

Prescription Drug - Brand

$25

—

17433987605

ENEMEEZ MINI ENEMA

Prescription Drug - Brand

$0

—

17433987703

ENEMEEZ PLUS MINI ENEMA

Prescription Drug - Brand

$0

—

17478017424

XOPENEX 1.25 MG/3 ML SOLUTION

Prescription Drug - Brand

$3

—

17478045016

LORTAB 10 MG-300 MG/15 ML ELXR

Prescription Drug - Brand

$0

—

17478060930

ZIOPTAN 0.0015% EYE DROPS

Prescription Drug - Brand

$7

—

17772010130

TROKENDI XR 25 MG CAPSULE

Prescription Drug - Brand

$12

—

17772010230

TROKENDI XR 50 MG CAPSULE

Prescription Drug - Brand

$16

—

17772010330

TROKENDI XR 100 MG CAPSULE

Prescription Drug - Brand

$32

—

17772010430

TROKENDI XR 200 MG CAPSULE

Prescription Drug - Brand

$44

—

17772012101

OXTELLAR XR 150 MG TABLET

Prescription Drug - Brand

$9

—

17772012201

OXTELLAR XR 300 MG TABLET

Prescription Drug - Brand

$13

—

17772012301

OXTELLAR XR 600 MG TABLET

Prescription Drug - Brand

$23

—

17772013130

QELBREE ER 100 MG CAPSULE

Prescription Drug - Brand

$13

—

17772013230

QELBREE ER 150 MG CAPSULE

Prescription Drug - Brand

$13

—

17772013360

QELBREE ER 200 MG CAPSULE

Prescription Drug - Brand

$13

—

18657011704

HYLENEX 150 UNITS/ML VIAL

Prescription Drug - Brand

$53

—

18860010210

FAZACLO 25 MG ODT

Prescription Drug - Brand

$4

—

18860010401

FAZACLO 100 MG ODT

Prescription Drug - Brand

$15

—

18860010610

FAZACLO 200 MG ODT

Prescription Drug - Brand

$28

—

20482000230

SUBSYS 200 MCG SPRAY

Prescription Drug - Brand

$82

—

21724070105

PROCENTRA 5 MG/5 ML SOLUTION

Prescription Drug - Brand

$2

—

23359003216

NINJACOF LIQUID

Prescription Drug - Brand

$0

—

23359003416

NINJACOF-D LIQUID

Prescription Drug - Brand

$0

—

23594010105

KARBINAL ER 4 MG/5 ML SUSP

Prescription Drug - Brand

$1

—

23594050050

POLY-VI-FLOR 0.25 MG DROPS

Prescription Drug - Brand

$6

—

23594051008

MILLIPRED 10 MG/5 ML SOLUTION

Prescription Drug - Brand

$3

—

23594078088

ULESFIA 5% LOTION

Prescription Drug - Brand

$1

—

23635011501

XARTEMIS XR 7.5-325 MG TABLET

Prescription Drug - Brand

$2

—

23635031015

PENNSAID 1.5% SOLUTION

Prescription Drug - Brand

$2

—

23635040801

EXALGO ER 8 MG TABLET

Prescription Drug - Brand

$12

—

23635041201

EXALGO ER 12 MG TABLET

Prescription Drug - Brand

$19

—

23635041601

EXALGO ER 16 MG TABLET

Prescription Drug - Brand

$25

—

23635043201

EXALGO ER 32 MG TABLET

Prescription Drug - Brand

$50

—

23635050860

AMITIZA 8 MCG CAPSULE

Prescription Drug - Brand

$6

—

23635052460

AMITIZA 24 MCG CAPSULE

Prescription Drug - Brand

$6

—

23635058110

ROXICODONE 15 MG TABLET

Prescription Drug - Brand

$5

—

23635058210

ROXICODONE 30 MG TABLET

Prescription Drug - Brand

$11

—

24090041004

NITROMIST 400 MCG SPRAY

Prescription Drug - Brand

$99

—

24090047188

INDERAL LA 80 MG CAPSULE

Prescription Drug - Brand

$20

—

24090047388

INDERAL LA 120 MG CAPSULE

Prescription Drug - Brand

$24

—

Prescription Drug - Brand Procedures

My Cost List