Prescription Drug - Brand Procedure Costs — 3320 Procedures

65224032060

ZOHYDRO ER 20 MG CAPSULE

Prescription Drug - Brand

$10

—

65224033060

ZOHYDRO ER 30 MG CAPSULE

Prescription Drug - Brand

$11

—

65224034060

ZOHYDRO ER 40 MG CAPSULE

Prescription Drug - Brand

$11

—

65224035060

ZOHYDRO ER 50 MG CAPSULE

Prescription Drug - Brand

$11

—

65224070711

OMECLAMOX-PAK COMBO PACK

Prescription Drug - Brand

$7

—

65483089403

LOTRONEX 0.5 MG TABLET

Prescription Drug - Brand

$29

—

65483089503

LOTRONEX 1 MG TABLET

Prescription Drug - Brand

$57

—

65597011190

AZOR 10-20 MG TABLET

Prescription Drug - Brand

$8

—

65597011490

TRIBENZOR 20-5-12.5 MG TABLET

Prescription Drug - Brand

$8

—

65597011690

TRIBENZOR 40-5-25 MG TABLET

Prescription Drug - Brand

$10

—

65597011730

TRIBENZOR 40-10-12.5 MG TABLET

Prescription Drug - Brand

$11

—

65597020230

SAVAYSA 30 MG TABLET

Prescription Drug - Brand

$15

—

65597020330

SAVAYSA 60 MG TABLET

Prescription Drug - Brand

$15

—

65597030110

MORPHABOND ER 15 MG TABLET

Prescription Drug - Brand

$5

—

65597030210

MORPHABOND ER 30 MG TABLET

Prescription Drug - Brand

$11

—

65597090230

WELCHOL 3.75G PACKET

Prescription Drug - Brand

$22

—

65628005301

FIRST-MARY'S MOUTHWASH

Prescription Drug - Brand

$0

—

65628020510

FIRVANQ 25 MG/ML SOLUTION

Prescription Drug - Brand

$0

—

65628020605

FIRVANQ 50 MG/ML SOLUTION

Prescription Drug - Brand

$1

—

65628027210

KONVOMEP 2-84 MG/ML ORAL SUSP

Prescription Drug - Brand

$1

—

65649000330

TRULANCE 3 MG TABLET

Prescription Drug - Brand

$19

—

65649010302

APRISO ER 0.375 GRAM CAPSULE

Prescription Drug - Brand

$4

—

65649015090

RELISTOR 150 MG TABLET

Prescription Drug - Brand

$27

—

65649020175

MOVIPREP POWDER PACKET

Prescription Drug - Brand

$120

—

65649030103

XIFAXAN 200 MG TABLET

Prescription Drug - Brand

$11

—

65649030303

XIFAXAN 550 MG TABLET

Prescription Drug - Brand

$55

—

65649031112

DIURIL 250 MG/5 ML ORAL SUSP

Prescription Drug - Brand

$0

—

65649040001

PLENVU POWDER PACKETS

Prescription Drug - Brand

$48

—

65649055102

RELISTOR 12 MG/0.6 ML VIAL

Prescription Drug - Brand

$272

—

65649055103

RELISTOR 12 MG/0.6 ML SYRINGE

Prescription Drug - Brand

$273

—

65649055204

RELISTOR 8 MG/0.4 ML SYRINGE

Prescription Drug - Brand

$410

—

65649065103

UCERIS 2 MG RECTAL FOAM

Prescription Drug - Brand

$12

—

65649070141

OSMOPREP TABLET

Prescription Drug - Brand

$8

—

65757030001

VIVITROL 380 MG VIAL-DILUENT

Prescription Drug - Brand

$1,719

—

65757030202

VIVITROL 380 MG VIAL

Prescription Drug - Brand

$1,626

—

65757040103

ARISTADA ER 441 MG/1.6 ML SYRN

Prescription Drug - Brand

$1,000

—

65757040203

ARISTADA ER 662 MG/2.4 ML SYRN

Prescription Drug - Brand

$1,001

—

65757040303

ARISTADA ER 882 MG/3.2 ML SYRN

Prescription Drug - Brand

$1,000

—

65757040403

ARISTADA ER 1,064 MG/3.9 ML SYR

Prescription Drug - Brand

$988

—

65757050003

ARISTADA INITIO ER 675 MG/2.4

Prescription Drug - Brand

$1,027

—

65757065142

LYBALVI 5-10 MG TABLET

Prescription Drug - Brand

$55

—

65757065242

LYBALVI 10-10 MG TABLET

Prescription Drug - Brand

$55

—

65757065342

LYBALVI 15-10 MG TABLET

Prescription Drug - Brand

$55

—

65757065442

LYBALVI 20-10 MG TABLET

Prescription Drug - Brand

$55

—

66220063731

SANCUSO 3.1 MG/24 HR PATCH

Prescription Drug - Brand

$669

—

66220071930

KRISTALOSE 10 GM PACKET

Prescription Drug - Brand

$10

—

66220072930

KRISTALOSE 20 GM PACKET

Prescription Drug - Brand

$10

—

66302046760

ADCIRCA 20 MG TABLET

Prescription Drug - Brand

$67

—

66490069010

MYSOLINE 50 MG TABLET

Prescription Drug - Brand

$12

—

66490069110

MYSOLINE 250 MG TABLET

Prescription Drug - Brand

$66

—

Prescription Drug - Brand Procedures

My Cost List