Prescription Drug - Generic Procedure Costs — 6726 Procedures

72603019601

NITROFURANTOIN MONO-MCR 100 MG

Prescription Drug - Generic

$0

—

72603019801

ZOLEDRONIC ACID 4 MG/5 ML VIAL

Prescription Drug - Generic

$5

—

72603020701

DICLOFENAC 2% SOLUTION PUMP

Prescription Drug - Generic

$0

—

72603023001

HALOPERIDOL DEC 100 MG/ML VIAL

Prescription Drug - Generic

$18

—

72603023301

DEFERASIROX 360 MG TABLET

Prescription Drug - Generic

$2

—

72603024001

GLYCOPYRROLATE 1 MG/5 ML ORAL SOLUTION

Prescription Drug - Generic

$0

—

72603024130

ESTRADIOL 0.1% (0.25 MG) GEL PK

Prescription Drug - Generic

$2

—

72603024230

ESTRADIOL 0.1% (0.5 MG) GEL PKT

Prescription Drug - Generic

$1

—

72603024330

ESTRADIOL 0.1% (0.75 MG) GEL PK

Prescription Drug - Generic

$1

—

72603024430

ESTRADIOL 0.1% (1 MG) GEL PKT

Prescription Drug - Generic

$2

—

72603024530

ESTRADIOL 0.1% (1.25 MG) GEL PK

Prescription Drug - Generic

$1

—

72603024601

ZILEUTON ER 600 MG TABLET

Prescription Drug - Generic

$2

—

72603024701

ENALAPRIL 1 MG/ML ORAL SOLN

Prescription Drug - Generic

$1

—

72603024801

ATOVAQUONE 750 MG/5 ML SUSP

Prescription Drug - Generic

$1

—

72603025501

EVEROLIMUS 5 MG TABLET

Prescription Drug - Generic

$15

—

72603025701

EVEROLIMUS 10 MG TABLET

Prescription Drug - Generic

$26

—

72603026002

DIVALPROEX DR 125 MG CAP SPRNK

Prescription Drug - Generic

$0

—

72603026101

RUFINAMIDE 40 MG/ML SUSPENSION

Prescription Drug - Generic

$0

—

72603026201

PYRIMETHAMINE 25 MG TABLET

Prescription Drug - Generic

$137

—

72603026402

ATROPINE 1% EYE DROPS

Prescription Drug - Generic

$6

—

72603026501

TESTOSTERONE 1.62% GEL PUMP

Prescription Drug - Generic

$0

—

72603027301

ESTRADIOL 0.5 MG TABLET

Prescription Drug - Generic

$0

—

72603027402

ESTRADIOL 1 MG TABLET

Prescription Drug - Generic

$0

—

72603027502

ESTRADIOL 2 MG TABLET

Prescription Drug - Generic

$0

—

72603027802

SOD SUL-POTASS SUL-MAG SUL SOL

Prescription Drug - Generic

$0

—

72603027901

BUPIVACAINE 0.25% 125 MG/50 ML VL

Prescription Drug - Generic

$0

—

72603028601

TESTOSTERONE CYP 200 MG/ML

Prescription Drug - Generic

$11

—

72603028701

BUPIVACAINE 0.5% 250 MG/50 ML VL

Prescription Drug - Generic

$0

—

72603028801

LUBIPROSTONE 8 MCG CAPSULE

Prescription Drug - Generic

$1

—

72603028901

LUBIPROSTONE 24 MCG CAPSULE

Prescription Drug - Generic

$1

—

72603029002

OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB

Prescription Drug - Generic

$0

—

72603029102

OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB

Prescription Drug - Generic

$0

—

72603029202

OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB

Prescription Drug - Generic

$0

—

72603030204

POLYETHYLENE GLYCOL 3350 POWD

Prescription Drug - Generic

$1

—

72603030401

MESALAMINE DR 1.2 GM TABLET

Prescription Drug - Generic

$1

—

72603030501

LACOSAMIDE 10 MG/ML SOLUTION

Prescription Drug - Generic

$0

—

72603031310

LANSOPRAZOLE DR 15 MG ODT

Prescription Drug - Generic

$2

—

72603031410

LANSOPRAZOLE DR 30 MG ODT

Prescription Drug - Generic

$2

—

72603031501

METHIMAZOLE 5 MG TABLET

Prescription Drug - Generic

$0

—

72603031601

METHIMAZOLE 10 MG TABLET

Prescription Drug - Generic

$0

—

72603031730

PANTOPRAZOLE DR 40 MG SUSP PKT

Prescription Drug - Generic

$4

—

72603031901

TRIAMCINOLONE 0.05% OINTMENT

Prescription Drug - Generic

$0

—

72603032102

CLINDAMYCIN PH 1% SOLUTION

Prescription Drug - Generic

$0

—

72603032201

CLIND PH-BENZOYL PEROX 1.2-5%

Prescription Drug - Generic

$0

—

72603032304

CLOBETASOL 0.05% CREAM

Prescription Drug - Generic

$0

—

72603032901

EXEMESTANE 25 MG TABLET

Prescription Drug - Generic

$1

—

72603035025

LIDOCAINE HCL 1% 20 MG/2 ML VL

Prescription Drug - Generic

$1

—

72603039001

DOXEPIN 10 MG CAPSULE

Prescription Drug - Generic

$0

—

72603039101

DOXEPIN 25 MG CAPSULE

Prescription Drug - Generic

$0

—

72603039201

DOXEPIN 50 MG CAPSULE

Prescription Drug - Generic

$0

—

Prescription Drug - Generic Procedures

My Cost List