Medical Procedure Costs

43520

Incision of pyloric muscle

Surgery - Digestive

$681

—

43538017069

CLINDACIN P 1% PLEDGETS

Prescription Drug - Brand

$9

—

43538017169

CLINDACIN PAC KIT

Prescription Drug - Brand

$290

—

43538017360

CLINDACIN ETZ KIT

Prescription Drug - Brand

$290

—

43538017645

NEUAC GEL

Prescription Drug - Brand

$7

—

43538017910

CLINDACIN 1% FOAM

Prescription Drug - Generic

$3

—

43538019016

SUMADAN 9%-4.5% WASH

Prescription Drug - Brand

$2

—

43538019116

SUMADAN KIT

Prescription Drug - Brand

$804

—

43538053010

KETODAN 2% FOAM

Prescription Drug - Generic

$3

—

43538094060

NEO-SYNALAR 0.5%-0.025% CREAM

Prescription Drug - Brand

$13

—

43538095004

CLODAN 0.05% SHAMPOO

Prescription Drug - Generic

$0

—

43538095210

TOVET EMOLLIENT 0.05% FOAM

Prescription Drug - Generic

$2

—

43547038209

DONEPEZIL HCL 23 MG TABLET

Prescription Drug - Generic

$1

—

43547040903

PAROXETINE MESYLATE 7.5 MG CAP

Prescription Drug - Generic

$3

—

43547046212

DOXYCYCLINE HYC DR 50 MG TAB

Prescription Drug - Generic

$2

—

43553324908

ALOE VESTA 43% PROTECTIVE OINT

Prescription Drug - Generic

$0

—

43553325614

SENSI-CARE PROTECTIVE OINTMENT

Prescription Drug - Generic

$0

—

43595008003

OLEPTRO ER 150 MG TABLET

Prescription Drug - Brand

$3

—

43598002114

AUGMENTIN 875-125 TABLET

Prescription Drug - Brand

$63

—

43598013101

HYDROXYCHLOROQUINE 400 MG TAB

Prescription Drug - Generic

$1

—

43598013201

HYDROXYCHLOROQUINE 300 MG TAB

Prescription Drug - Generic

$1

—

43598013301

HYDROXYCHLOROQUINE 100 MG TAB

Prescription Drug - Generic

$0

—

43598021085

SSD 1% CREAM

Prescription Drug - Generic

$0

—

43598022040

AMOXICILLIN-CLAV ER 1,000-62.5

Prescription Drug - Generic

$3

—

43598026525

PROPOFOL 200 MG/20 ML VIAL

Prescription Drug - Generic

$0

—

43598044556

NICOTINE TRANSDERMAL SYSTEM

Prescription Drug - Generic

$1

—

43598061860

SAXAGLIPTIN-METFORMIN ER 2.5-1,000 MG TABLET

Prescription Drug - Generic

$5

—

43598061930

SAXAGLIPTIN-METFORMIN ER 5-1,000 MG TABLET

Prescription Drug - Generic

$11

—

43598076507

OLOPATADINE HCL 0.1% EYE DROPS

Prescription Drug - Generic

$1

—

43598089330

NITROGLYCERIN 0.6 MG/HR PATCH

Prescription Drug - Generic

$1

—

43598089430

NITROGLYCERIN 0.4 MG/HR PATCH

Prescription Drug - Generic

$1

—

43598089530

NITROGLYCERIN 0.2 MG/HR PATCH

Prescription Drug - Generic

$1

—

43598089630

NITROGLYCERIN 0.1 MG/HR PATCH

Prescription Drug - Generic

$0

—

43605

Biopsy of stomach

Surgery - Digestive

$801

—

43610

Excision of stomach lesion

Surgery - Digestive

$920

—

43611

Excision of stomach lesion

Surgery - Digestive

$1,149

—

43620

Removal of stomach

Surgery - Digestive

$1,834

—

43621

Removal of stomach

Surgery - Digestive

$2,092

—

43622

Removal of stomach

Surgery - Digestive

$2,129

—

43631

Removal of stomach partial

Surgery - Digestive

$1,356

—

43632

Removal of stomach partial

Surgery - Digestive

$1,875

—

43633

Removal of stomach partial

Surgery - Digestive

$1,776

—

43634

Removal of stomach partial

Surgery - Digestive

$1,962

—

43635

Removal of stomach partial

Surgery - Digestive

$101

—

43640

Vagotomy & pylorus repair

Surgery - Digestive

$1,122

—

43641

Vagotomy & pylorus repair

Surgery - Digestive

$1,134

—

43644

Lap gastric bypass/roux-en-y

Surgery - Digestive

$1,618

—

43645

Lap gastr bypass incl smll i

Surgery - Digestive

$1,718

—

43651

Laparoscopy vagus nerve

Surgery - Digestive

$634

—

43652

Laparoscopy vagus nerve

Surgery - Digestive

$732

—

My Cost List