Prescription Drug - Generic Procedure Costs — 6726 Procedures

65862088830

GLIPIZIDE ER 2.5 MG TABLET

Prescription Drug - Generic

$0

—

65862088905

GLIPIZIDE ER 5 MG TABLET

Prescription Drug - Generic

$0

—

65862089001

GLIPIZIDE ER 10 MG TABLET

Prescription Drug - Generic

$0

—

65862089788

NYLIA 7-7-7-28 TABLET

Prescription Drug - Generic

$0

—

65862089888

NYLIA 1-35 28 TABLET

Prescription Drug - Generic

$0

—

65862092205

TRAMADOL-ACETAMINOPHEN 37.5-325 MG TAB

Prescription Drug - Generic

$0

—

65862092585

INCASSIA 0.35 MG TABLET

Prescription Drug - Generic

$0

—

65862092836

SUMATRIPTAN-NAPROXEN 85-500 MG

Prescription Drug - Generic

$13

—

65862093488

AUROVELA 24 FE 1 MG-20 MCG TAB

Prescription Drug - Generic

$0

—

65862093574

AUROVELA 21 1.5-30 TABLET

Prescription Drug - Generic

$0

—

65862093988

AUROVELA 1 MG-20 MCG TABLET

Prescription Drug - Generic

$0

—

65862094088

AUROVELA FE 1-20 TABLET

Prescription Drug - Generic

$0

—

65862094188

AUROVELA FE 1.5 MG-30 MCG TAB

Prescription Drug - Generic

$0

—

65862094760

DORZOLAMIDE-TIMOLOL 2-0.5%(PF)

Prescription Drug - Generic

$1

—

66424052035

AUROGUARD OTIC SOLUTION

Prescription Drug - Generic

$0

—

66435010184

RIBASPHERE 200 MG CAPSULE

Prescription Drug - Generic

$1

—

66435010216

RIBASPHERE 200 MG TABLET

Prescription Drug - Generic

$1

—

66530025830

FLUOROURACIL 0.5% CREAM

Prescription Drug - Generic

$48

—

66594099905

MAXIMUM D3 10,000 UNITS CAP

Prescription Drug - Generic

$1

—

66685100101

AMOX TR-K CLV 875-125 MG TAB

Prescription Drug - Generic

$0

—

66685100202

AMOX TR-K CLV 500-125 MG TAB

Prescription Drug - Generic

$0

—

66685101102

AMOX TR-K CLV 200-28.5/5 SUSP

Prescription Drug - Generic

$0

—

66685101202

AMOX TR-K CLV 400-57/5 SUSP

Prescription Drug - Generic

$0

—

66689071116

METHADONE 5 MG/5 ML SOLUTION

Prescription Drug - Generic

$0

—

66870022016

12.5CPD-1DCPM-30PSE LIQUID

Prescription Drug - Generic

$0

—

66870040601

AMBI 60PSE-400GFN TABLET

Prescription Drug - Generic

$0

—

66870044201

AMBI 60PSE-4CPM TABLET

Prescription Drug - Generic

$0

—

66870044401

AMBI 10PEH-4CPM TABLET

Prescription Drug - Generic

$0

—

66993000210

ESTRADIOL 0.01% CREAM

Prescription Drug - Generic

$0

—

66993007896

FLUTICASONE PROPIONATE HFA 44 MCG INHALER

Prescription Drug - Generic

$12

—

66993007996

FLUTICASONE PROPIONATE HFA 110 MCG INHALER

Prescription Drug - Generic

$14

—

66993008096

FLUTICASONE PROPIONATE HFA 220 MCG INHALER

Prescription Drug - Generic

$22

—

66993008169

SUMATRIPTAN 5 MG NASAL SPRAY

Prescription Drug - Generic

$20

—

66993008398

SUMATRIPTAN 4 MG/0.5 ML INJECT

Prescription Drug - Generic

$133

—

66993008479

SUMATRIPTAN 6 MG/0.5 ML CART

Prescription Drug - Generic

$124

—

66993008498

SUMATRIPTAN 6 MG/0.5 ML INJECT

Prescription Drug - Generic

$66

—

66993008696

FLUTICASONE-SALMETEROL 45-21

Prescription Drug - Generic

$17

—

66993008796

FLUTICASONE-SALMETEROL 115-21

Prescription Drug - Generic

$21

—

66993008896

FLUTICASONE-SALMETEROL 230-21

Prescription Drug - Generic

$27

—

66993013497

UMECLIDINIUM-VILANTEROL ELLIPTA 62.5-25 MCG INH

Prescription Drug - Generic

$5

—

66993013597

FLUTICASONE-VILANTEROL 100-25

Prescription Drug - Generic

$4

—

66993013697

FLUTICASONE-VILANTEROL 200-25

Prescription Drug - Generic

$4

—

66993014130

ALISKIREN 150 MG TABLET

Prescription Drug - Generic

$4

—

66993014230

ALISKIREN 300 MG TABLET

Prescription Drug - Generic

$5

—

66993016697

FLUTICASONE ELLIPTA 50 MCG INH

Prescription Drug - Generic

$4

—

66993016797

FLUTICASONE ELLIPTA 100 MCG INH

Prescription Drug - Generic

$4

—

66993016897

FLUTICASONE ELLIPTA 200 MCG INH

Prescription Drug - Generic

$6

—

66993018550

DOXERCALCIFEROL 0.5 MCG CAP

Prescription Drug - Generic

$10

—

66993018650

DOXERCALCIFEROL 1 MCG CAPSULE

Prescription Drug - Generic

$18

—

66993018802

SPIRONOLACTONE-HYDROCHLOROTHIAZIDE 25-25 TAB

Prescription Drug - Generic

$1

—

Prescription Drug - Generic Procedures

My Cost List