Prescription Drug - Brand Procedure Costs — 3320 Procedures

59011045101

DILAUDID 5 MG/5 ML ORAL LIQUID

Prescription Drug - Brand

$1

—

59011046020

OXYCONTIN ER 60 MG TABLET

Prescription Drug - Brand

$27

—

59011048010

OXYCONTIN 80 MG TABLET

Prescription Drug - Brand

$20

—

59011048020

OXYCONTIN ER 80 MG TABLET

Prescription Drug - Brand

$33

—

59011075004

BUTRANS 5 MCG/HR PATCH

Prescription Drug - Brand

$49

—

59011075104

BUTRANS 10 MCG/HR PATCH

Prescription Drug - Brand

$74

—

59011075204

BUTRANS 20 MCG/HR PATCH

Prescription Drug - Brand

$131

—

59011075704

BUTRANS 7.5 MCG/HR PATCH

Prescription Drug - Brand

$69

—

59011075804

BUTRANS 15 MCG/HR PATCH

Prescription Drug - Brand

$125

—

59137050504

RASUVO 7.5 MG/0.15 ML AUTOINJ

Prescription Drug - Brand

$960

—

59137051004

RASUVO 10 MG/0.2 ML AUTOINJ

Prescription Drug - Brand

$722

—

59137051504

RASUVO 12.5 MG/0.25 ML AUTOINJ

Prescription Drug - Brand

$575

—

59137052004

RASUVO 15 MG/0.3 ML AUTOINJ

Prescription Drug - Brand

$482

—

59137052504

RASUVO 17.5 MG/0.35 ML AUTOINJ

Prescription Drug - Brand

$410

—

59137053004

RASUVO 20 MG/0.4 ML AUTOINJ

Prescription Drug - Brand

$361

—

59137054004

RASUVO 25 MG/0.5 ML AUTOINJ

Prescription Drug - Brand

$288

—

59148000613

ABILIFY 2 MG TABLET

Prescription Drug - Brand

$19

—

59148000713

ABILIFY 5 MG TABLET

Prescription Drug - Brand

$19

—

59148000813

ABILIFY 10 MG TABLET

Prescription Drug - Brand

$19

—

59148000913

ABILIFY 15 MG TABLET

Prescription Drug - Brand

$19

—

59148001013

ABILIFY 20 MG TABLET

Prescription Drug - Brand

$26

—

59148001113

ABILIFY 30 MG TABLET

Prescription Drug - Brand

$26

—

59148001315

ABILIFY 1 MG/ML SOLUTION

Prescription Drug - Brand

$6

—

59148002050

SAMSCA 15 MG TABLET

Prescription Drug - Brand

$300

—

59148003513

REXULTI 0.25 MG TABLET

Prescription Drug - Brand

$50

—

59148003613

REXULTI 0.5 MG TABLET

Prescription Drug - Brand

$50

—

59148003713

REXULTI 1 MG TABLET

Prescription Drug - Brand

$50

—

59148003813

REXULTI 2 MG TABLET

Prescription Drug - Brand

$50

—

59148003913

REXULTI 3 MG TABLET

Prescription Drug - Brand

$50

—

59148004013

REXULTI 4 MG TABLET

Prescription Drug - Brand

$50

—

59148004580

ABILIFY MAINTENA ER 300 MG SYR

Prescription Drug - Brand

$2,143

—

59148007280

ABILIFY MAINTENA ER 400 MG SYR

Prescription Drug - Brand

$2,860

—

59148010280

ABILIFY ASIMTUFII 720 MG/2.4 ML

Prescription Drug - Brand

$1,776

—

59148011480

ABILIFY ASIMTUFII 960 MG/3.2 ML

Prescription Drug - Brand

$1,782

—

59148023212

ABILIFY MAINTENA ER 300 MG VL

Prescription Drug - Brand

$2,139

—

59148024512

ABILIFY MAINTENA ER 400 MG VL

Prescription Drug - Brand

$2,856

—

59148064023

ABILIFY DISCMELT 10 MG TABLET

Prescription Drug - Brand

$35

—

59148064123

ABILIFY DISCMELT 15 MG TABLET

Prescription Drug - Brand

$34

—

59212020010

UROXATRAL 10 MG TABLET

Prescription Drug - Brand

$18

—

59212056210

PLAQUENIL 200 MG TABLET

Prescription Drug - Brand

$9

—

59212065860

KAPVAY ER 0.1 MG TABLET

Prescription Drug - Brand

$7

—

59310011106

AIRDUO DIGIHALER 55-14 MCG

Prescription Drug - Brand

$420

—

59310011720

PROAIR DIGIHALER 90 MCG INHALR

Prescription Drug - Brand

$86

—

59310012906

AIRDUO DIGIHALER 113-14 MCG

Prescription Drug - Brand

$419

—

59310013606

AIRDUO DIGIHALER 232-14 MCG

Prescription Drug - Brand

$474

—

59310020006

ARMONAIR DIGIHALER 113 MCG

Prescription Drug - Brand

$252

—

59310020212

QVAR 40 MCG ORAL INHALER

Prescription Drug - Brand

$19

—

59310020412

QVAR 80 MCG ORAL INHALER

Prescription Drug - Brand

$25

—

59310030240

QVAR REDIHALER 40 MCG

Prescription Drug - Brand

$21

—

59310030480

QVAR REDIHALER 80 MCG

Prescription Drug - Brand

$28

—

Prescription Drug - Brand Procedures

My Cost List