Prescription Drug - Brand Procedure Costs — 3320 Procedures

24208000401

ISTALOL 0.5% EYE DROPS

Prescription Drug - Brand

$80

—

24208027615

MURO-128 2% EYE DROPS

Prescription Drug - Brand

$1

—

24208027715

MURO-128 5% EYE DROPS

Prescription Drug - Brand

$1

—

24208029910

LOTEMAX 0.5% EYE DROPS

Prescription Drug - Brand

$62

—

24208035310

ALREX 0.2% EYE DROPS

Prescription Drug - Brand

$58

—

24208035805

ZYLET EYE DROPS

Prescription Drug - Brand

$64

—

24208037705

MIEBO 100% EYE DROP

Prescription Drug - Brand

$264

—

24208038555

MURO-128 5% EYE OINTMENT

Prescription Drug - Brand

$5

—

24208044335

LOTEMAX 0.5% EYE OINTMENT

Prescription Drug - Brand

$100

—

24208044605

BESIVANCE 0.6% SUSP

Prescription Drug - Brand

$44

—

24208049968

TIMOPTIC 0.5% OCUDOSE DROP

Prescription Drug - Brand

$10

—

24208050307

LOTEMAX 0.5% OPHTHALMIC GEL

Prescription Drug - Brand

$50

—

24208050405

VYZULTA 0.024% OPHTH SOLUTION

Prescription Drug - Brand

$102

—

24208050707

LOTEMAX SM 0.38% OPHTH GEL

Prescription Drug - Brand

$49

—

24208053535

ZIRGAN 0.15% OPHTHALMIC GEL

Prescription Drug - Brand

$91

—

24208053725

LUMIFY 0.025% EYE DROP

Prescription Drug - Brand

$2

—

24208060105

CHILD'S ALAWAY 0.025% EYE DROP

Prescription Drug - Brand

$2

—

24208060110

ALAWAY 0.025% EYE DROPS

Prescription Drug - Brand

$1

—

24208060203

PROLENSA 0.07% EYE DROPS

Prescription Drug - Brand

$116

—

24208062902

BEPREVE 1.5% EYE DROPS

Prescription Drug - Brand

$56

—

24208080060

LACRISERT 5 MG EYE INSERT

Prescription Drug - Brand

$8

—

24208091112

XIIDRA 5% EYE DROPS

Prescription Drug - Brand

$12

—

24338001009

BIDIL 20 MG-37.5 MG TABLET

Prescription Drug - Brand

$4

—

24338001018

BIDIL TABLET

Prescription Drug - Brand

$4

—

24338001690

ADTHYZA 16.25 MG TABLET

Prescription Drug - Brand

$1

—

24338002010

EVEKEO 5 MG TABLET

Prescription Drug - Brand

$6

—

24338002603

EVEKEO 10 MG TABLET

Prescription Drug - Brand

$8

—

24338003290

ADTHYZA 32.5 MG TABLET

Prescription Drug - Brand

$1

—

24338003301

EVEKEO ODT 10 MG

Prescription Drug - Brand

$7

—

24338006590

ADTHYZA 65 MG TABLET

Prescription Drug - Brand

$1

—

24338008014

OTOVEL 0.3%-0.025% EAR DROPS

Prescription Drug - Brand

$17

—

24338009790

ADTHYZA 97.5 MG TABLET

Prescription Drug - Brand

$1

—

24338010620

ERYTHROCIN 250 MG FILMTAB

Prescription Drug - Brand

$10

—

24338013013

ERYPED 400 MG/5 ML SUSPENSION

Prescription Drug - Brand

$6

—

24338013213

ERYPED 200 MG/5 ML SUSPENSION

Prescription Drug - Brand

$4

—

24338013402

E.E.S. 200 MG/5 ML GRANULES

Prescription Drug - Brand

$4

—

24338018504

SKLICE 0.5% LOTION

Prescription Drug - Brand

$0

—

24338030020

NITROLINGUAL 0.4 MG SPRAY

Prescription Drug - Brand

$31

—

24338053048

SOTYLIZE 5 MG/ML ORAL SOLUTION

Prescription Drug - Brand

$2

—

24338085603

ZENZEDI 30 MG TABLET

Prescription Drug - Brand

$10

—

24478007401

QUILLICHEW ER 20 MG CHEW TAB

Prescription Drug - Brand

$12

—

24478007501

QUILLICHEW ER 30 MG CHEW TAB

Prescription Drug - Brand

$12

—

24478007601

QUILLICHEW ER 40 MG CHEW TAB

Prescription Drug - Brand

$12

—

24478010201

DYANAVEL XR 2.5 MG/ML SUSP

Prescription Drug - Brand

$3

—

24478010601

DYANAVEL XR 5 MG TABLET

Prescription Drug - Brand

$8

—

24478010801

DYANAVEL XR 10 MG TABLET

Prescription Drug - Brand

$15

—

24478010901

DYANAVEL XR 15 MG TABLET

Prescription Drug - Brand

$15

—

24478011001

DYANAVEL XR 20 MG TABLET

Prescription Drug - Brand

$15

—

24478014803

ONYDA XR 0.1 MG/ML SUSPENSION

Prescription Drug - Brand

$13

—

24478032406

QUILLIVANT XR 25 MG/5 ML SUSP

Prescription Drug - Brand

$2

—

Prescription Drug - Brand Procedures

My Cost List