Medical Procedure Costs

49348087359

SM IBUPROFEN PM CAPLET

Prescription Drug - Generic

$0

—

49348087934

SM CHILDRENS PLUS COLD SUSP

Prescription Drug - Generic

$0

—

49348088384

SM ARTHRICREAM RUB 10% CREAM

Prescription Drug - Generic

$0

—

49348089350

SM CLEARLAX POWDER

Prescription Drug - Generic

$0

—

49348089429

SM REDNESS RELIEF EYE DROPS

Prescription Drug - Generic

$0

—

49348090334

SM COUGH RELIEF LIQUID

Prescription Drug - Generic

$0

—

49348090470

SM FLU RELIEF THERAPY LIQUID

Prescription Drug - Generic

$0

—

49348090547

SM MUCUS ER 600 MG TABLET

Prescription Drug - Generic

$0

—

49348091609

SM GLUCOSE 4 GRAM TAB CHEW

Prescription Drug - Generic

$0

—

49348092044

SM WOMAN'S LAXATIVE 5 MG TAB

Prescription Drug - Generic

$0

—

49348092110

SM ARTHRITIS PAIN ER 650 MG

Prescription Drug - Generic

$0

—

49348092237

SM STOMACH RELIEF 262 MG/15 ML

Prescription Drug - Generic

$0

—

49348092337

SM STOMACH RELIEF LIQUID

Prescription Drug - Generic

$0

—

49348092410

SM 8 HOUR PAIN RELIEF 650 MG

Prescription Drug - Generic

$0

—

49348092710

SM IBUPROFEN IB 200 MG TABLET

Prescription Drug - Generic

$0

—

49348093001

SM LORATADINE 10 MG ODT

Prescription Drug - Generic

$0

—

49348093434

SM CHILD ALL DAY ALLER 1 MG/ML

Prescription Drug - Generic

$0

—

49348094059

SM NAPROXEN SODIUM 220 MG CAP

Prescription Drug - Generic

$0

—

49348094102

SM URINARY PAIN REL 97.5 MG TB

Prescription Drug - Generic

$0

—

49348094729

SM LUBRICANT EYE DROPS

Prescription Drug - Generic

$0

—

49348095004

SM HEMORRHOIDAL SUPPOSITORY

Prescription Drug - Generic

$0

—

49348095721

SM CAL ANTACID 500 MG CHW TAB

Prescription Drug - Generic

$0

—

49348096029

SM EAR DROPS 6.5%

Prescription Drug - Generic

$0

—

49348097310

SM PAIN RELIEVER 325 MG TABLET

Prescription Drug - Generic

$0

—

49348097967

SM LAXATIVE 10 MG SUPPOSITORY

Prescription Drug - Generic

$0

—

49348098115

SM ASPIRIN EC 81 MG TABLET

Prescription Drug - Generic

$0

—

49348098504

SM SINUS & ALLERGY TABLET

Prescription Drug - Generic

$0

—

49348098605

SM COUGH DROPS 5.8 MG

Prescription Drug - Generic

$0

—

49348098844

SM COUGH DROPS

Prescription Drug - Generic

$0

—

49348099044

SM COUGH DROPS 5.4 MG

Prescription Drug - Generic

$0

—

49348099136

SM SORE THROAT 1.4% SPRAY

Prescription Drug - Generic

$0

—

49348099810

SM PAIN RELIEVER 500 MG TABLET

Prescription Drug - Generic

$0

—

49348099934

SM LOPERAMIDE 1 MG/7.5 ML LIQ

Prescription Drug - Generic

$0

—

49400

Air injection into abdomen

Surgery - Digestive

$78

—

49402

Remove foreign body adbomen

Surgery - Digestive

$800

—

49405

Image cath fluid colxn visc

Surgery - Digestive

$167

—

49406

Image cath fluid peri/retro

Surgery - Digestive

$167

—

49407

Image cath fluid trns/vgnl

Surgery - Digestive

$180

—

49411

Ins mark abd/pel for rt perq

Surgery - Digestive

$158

—

49411005030

AMICAR 500 MG TABLET

Prescription Drug - Brand

$19

—

49412

Ins device for rt guide open

Surgery - Digestive

$74

—

49418

Insert tun ip cath perc

Surgery - Digestive

$175

—

49419

Insert tun ip cath w/port

Surgery - Digestive

$391

—

49421

Ins tun ip cath for dial opn

Surgery - Digestive

$207

—

49422

Remove tunneled ip cath

Surgery - Digestive

$202

—

49423

Exchange drainage catheter

Surgery - Digestive

$61

—

49424

Assess cyst contrast inject

Surgery - Digestive

$32

—

49425

Insert abdomen-venous drain

Surgery - Digestive

$747

—

49426

Revise abdomen-venous shunt

Surgery - Digestive

$643

—

49427

Injection abdominal shunt

Surgery - Digestive

$35

—

My Cost List