Prescription Drug - Brand Procedure Costs — 3320 Procedures

59310040606

QNASL CHILDREN'S 40 MCG SPRAY

Prescription Drug - Brand

$47

—

59310041012

QNASL 80 MCG NASAL SPRAY

Prescription Drug - Brand

$30

—

59310057922

PROAIR HFA 90 MCG INHALER

Prescription Drug - Brand

$8

—

59310058020

PROAIR RESPICLICK INHAL POWDER

Prescription Drug - Brand

$58

—

59310081206

AIRDUO RESPICLICK 113-14 MCG

Prescription Drug - Brand

$386

—

59310082206

AIRDUO RESPICLICK 232-14 MCG

Prescription Drug - Brand

$385

—

59316010228

BIOFREEZE 4% GEL

Prescription Drug - Brand

$0

—

59316020714

BIOFREEZE 4% GEL ROLL-ON

Prescription Drug - Brand

$0

—

59316083310

BIOFREEZE 10.5% SPRAY

Prescription Drug - Brand

$0

—

59365503000

TRIMO-SAN JELLY

Prescription Drug - Brand

$0

—

59385001230

BUNAVAIL 2.1-0.3 MG FILM

Prescription Drug - Brand

$8

—

59385001430

BUNAVAIL 4.2-0.7 MG FILM

Prescription Drug - Brand

$8

—

59385001630

BUNAVAIL 6.3-1 MG FILM

Prescription Drug - Brand

$17

—

59385002160

BELBUCA 75 MCG FILM

Prescription Drug - Brand

$8

—

59385002260

BELBUCA 150 MCG FILM

Prescription Drug - Brand

$8

—

59385002360

BELBUCA 300 MCG FILM

Prescription Drug - Brand

$12

—

59385002460

BELBUCA 450 MCG FILM

Prescription Drug - Brand

$16

—

59385002560

BELBUCA 600 MCG FILM

Prescription Drug - Brand

$17

—

59385002660

BELBUCA 750 MCG FILM

Prescription Drug - Brand

$18

—

59385002760

BELBUCA 900 MCG FILM

Prescription Drug - Brand

$19

—

59385004130

SYMPROIC 0.2 MG TABLET

Prescription Drug - Brand

$16

—

59417010110

VYVANSE 10 MG CAPSULE

Prescription Drug - Brand

$12

—

59417010210

VYVANSE 20 MG CAPSULE

Prescription Drug - Brand

$12

—

59417010310

VYVANSE 30 MG CAPSULE

Prescription Drug - Brand

$12

—

59417010410

VYVANSE 40 MG CAPSULE

Prescription Drug - Brand

$12

—

59417010510

VYVANSE 50 MG CAPSULE

Prescription Drug - Brand

$12

—

59417010610

VYVANSE 60 MG CAPSULE

Prescription Drug - Brand

$12

—

59417010710

VYVANSE 70 MG CAPSULE

Prescription Drug - Brand

$12

—

59417011501

VYVANSE 10 MG CHEWABLE TABLET

Prescription Drug - Brand

$12

—

59417011601

VYVANSE 20 MG CHEWABLE TABLET

Prescription Drug - Brand

$12

—

59417011701

VYVANSE 30 MG CHEWABLE TABLET

Prescription Drug - Brand

$12

—

59417011801

VYVANSE 40 MG CHEWABLE TABLET

Prescription Drug - Brand

$12

—

59417011901

VYVANSE 50 MG CHEWABLE TABLET

Prescription Drug - Brand

$12

—

59417012001

VYVANSE 60 MG CHEWABLE TABLET

Prescription Drug - Brand

$12

—

59467031830

MITIGARE 0.6 MG CAPSULE

Prescription Drug - Brand

$6

—

59467067901

KLOXXADO 8 MG NASAL SPRAY

Prescription Drug - Brand

$60

—

59467070027

RYALTRIS 665-25 MCG SPRAY

Prescription Drug - Brand

$8

—

59627000104

AVONEX ADMIN PACK 30 MCG VL

Prescription Drug - Brand

$1,398

—

59627000205

AVONEX PREFILLED SYR 30 MCG

Prescription Drug - Brand

$4,372

—

59627011103

AVONEX 30 MCG VIAL KIT

Prescription Drug - Brand

$1,663

—

59627022205

AVONEX 30 MCG/0.5 ML SYRINGE KIT (4 PACK)

Prescription Drug - Brand

$8,819

—

59627033304

AVONEX PEN 30 MCG/0.5 ML KIT (4 PACK)

Prescription Drug - Brand

$8,827

—

59630057560

FORTAMET ER 1,000 MG TABLET

Prescription Drug - Brand

$27

—

59630063030

ALTOPREV 60 MG TABLET

Prescription Drug - Brand

$25

—

59630070148

ORAPRED ODT 15 MG TABLET

Prescription Drug - Brand

$11

—

59630070248

ORAPRED ODT 30 MG TABLET

Prescription Drug - Brand

$14

—

59630075050

METHYLIN 5 MG/5 ML SOLUTION

Prescription Drug - Brand

$0

—

59630075550

METHYLIN 10 MG/5 ML SOLUTION

Prescription Drug - Brand

$0

—

59676022528

OLYSIO 150 MG CAPSULE

Prescription Drug - Brand

$781

—

59676027801

EDURANT 25 MG TABLET

Prescription Drug - Brand

$48

—

Prescription Drug - Brand Procedures

My Cost List