Prescription Drug - Brand Procedure Costs — 3320 Procedures

44087111601

GONAL-F RFF REDI-JECT 450 UNIT PEN

Prescription Drug - Brand

$1,847

—

44087111701

GONAL-F RFF REDI-JECT 900 UNIT PEN

Prescription Drug - Brand

$1,873

—

44087115001

OVIDREL 250 MCG/0.5 ML SYRG

Prescription Drug - Brand

$487

—

44087122501

CETROTIDE 0.25 MG VIAL

Prescription Drug - Brand

$306

—

44087334401

REBIF REBIDOSE 44 MCG/0.5 ML

Prescription Drug - Brand

$1,849

—

44087903001

GONAL-F 450 UNITS VIAL

Prescription Drug - Brand

$1,392

—

45802004201

CLINDESSE 2% VAGINAL CREAM

Prescription Drug - Brand

$27

—

45802039601

GYNAZOLE 1 2% CREAM

Prescription Drug - Brand

$23

—

46287002004

CAROSPIR 25 MG/5 ML SUSPENSION

Prescription Drug - Brand

$4

—

46287003001

ATORVALIQ 20 MG/5 ML SUSP

Prescription Drug - Brand

$1

—

46287003515

NORLIQVA 1 MG/ML SOLUTION

Prescription Drug - Brand

$3

—

46287004515

TADLIQ 20 MG/5 ML SUSPENSION

Prescription Drug - Brand

$13

—

47335050696

CEQUA 0.09% SOLUTION

Prescription Drug - Brand

$10

—

47335061630

DRIZALMA SPRINKLE DR 20 MG CAP

Prescription Drug - Brand

$7

—

47335061730

DRIZALMA SPRINKLE DR 30 MG CAP

Prescription Drug - Brand

$7

—

47335061830

DRIZALMA SPRINKLE DR 40 MG CAP

Prescription Drug - Brand

$7

—

47335061930

DRIZALMA SPRINKLE DR 60 MG CAP

Prescription Drug - Brand

$7

—

47335099436

WINLEVI 1% CREAM

Prescription Drug - Brand

$10

—

47918087490

AFREZZA (REGULAR INSULIN) 4 UNIT CARTRIDGE

Prescription Drug - Brand

$5

—

47918087890

AFREZZA ((REGULAR INSULIN) 8 UNIT CARTRIDGE

Prescription Drug - Brand

$10

—

47918088018

AFREZZA (REGULAR INSULIN) 90-4 UNIT / 90-8 UNIT

Prescription Drug - Brand

$8

—

47918089190

AFREZZA (REGULAR INSULIN) 12 UNIT CARTRIDGE

Prescription Drug - Brand

$15

—

47918089818

AFREZZA (REGULAR INSULIN) 90-8 UNIT / 90-12 UNIT

Prescription Drug - Brand

$13

—

47918090218

AFREZZA (REGULAR INSULIN) 60-4 UNIT/60-8 UNIT/60-12 UNIT

Prescription Drug - Brand

$10

—

49230053410

VENOFER 100 MG/5 ML VIAL

Prescription Drug - Brand

$12

—

49230064331

PHOSLYRA 667 MG/5 ML SOLUTION

Prescription Drug - Brand

$0

—

49230064551

VELPHORO 500 MG CHEWABLE TAB

Prescription Drug - Brand

$17

—

49411005030

AMICAR 500 MG TABLET

Prescription Drug - Brand

$19

—

49502019580

SEMGLEE 100 UNIT/ML VIAL

Prescription Drug - Brand

$9

—

49502019675

SEMGLEE 100 UNIT/ML PEN

Prescription Drug - Brand

$10

—

49502050001

EPIPEN 0.3 MG AUTO-INJECTOR

Prescription Drug - Brand

$290

—

49502050002

EPIPEN 2-PAK 0.3 MG AUTO-INJCT

Prescription Drug - Brand

$290

—

49502050101

EPIPEN JR 0.15 MG AUTO-INJECTR

Prescription Drug - Brand

$291

—

49502050102

EPIPEN JR 2-PAK 0.15 MG INJCTR

Prescription Drug - Brand

$291

—

49502060561

PERFOROMIST 20 MCG/2 ML SOLN

Prescription Drug - Brand

$10

—

49502080693

YUPELRI 175 MCG/3 ML SOLUTION

Prescription Drug - Brand

$17

—

49502090030

EMSAM 6 MG/24 HOURS PATCH

Prescription Drug - Brand

$75

—

49502090130

EMSAM 9 MG/24 HOURS PATCH

Prescription Drug - Brand

$75

—

49502090230

EMSAM 12 MG/24 HOURS PATCH

Prescription Drug - Brand

$75

—

49702020218

COMBIVIR TABLET

Prescription Drug - Brand

$14

—

49702020413

EPIVIR 300 MG TABLET

Prescription Drug - Brand

$13

—

49702020548

EPIVIR 10 MG/ML ORAL SOLN

Prescription Drug - Brand

$0

—

49702020613

EPZICOM TABLET

Prescription Drug - Brand

$41

—

49702020718

LEXIVA 700 MG TABLET

Prescription Drug - Brand

$19

—

49702021718

TRIZIVIR TABLET

Prescription Drug - Brand

$26

—

49702022144

ZIAGEN 300 MG TABLET

Prescription Drug - Brand

$9

—

49702022318

SELZENTRY 150 MG TABLET

Prescription Drug - Brand

$28

—

49702022418

SELZENTRY 300 MG TABLET

Prescription Drug - Brand

$28

—

49702022813

TIVICAY 50 MG TABLET

Prescription Drug - Brand

$78

—

49702023113

TRIUMEQ TABLET

Prescription Drug - Brand

$91

—

Prescription Drug - Brand Procedures

My Cost List