Medical Procedure Costs

50458034660

PANCREAZE DR 21,000 UNIT CAP

Prescription Drug - Brand

$6

—

50458035006

RISPERDAL 4 MG TABLET

Prescription Drug - Brand

$12

—

50458051380

TYLENOL WITH CODEINE #3 TABLET

Prescription Drug - Brand

$1

—

50458051570

TYLENOL WITH CODEINE #4 TABLET

Prescription Drug - Brand

$2

—

50458054060

INVOKAMET 50-500 MG TABLET

Prescription Drug - Brand

$10

—

50458054160

INVOKAMET 50-1,000 MG TABLET

Prescription Drug - Brand

$10

—

50458054260

INVOKAMET 150-500 MG TABLET

Prescription Drug - Brand

$10

—

50458054360

INVOKAMET 150-1,000 MG TABLET

Prescription Drug - Brand

$10

—

50458055001

INVEGA ER 3 MG TABLET

Prescription Drug - Brand

$12

—

50458055101

INVEGA ER 6 MG TABLET

Prescription Drug - Brand

$12

—

50458055201

INVEGA ER 9 MG TABLET

Prescription Drug - Brand

$19

—

50458055401

INVEGA ER 1.5 MG TABLET

Prescription Drug - Brand

$12

—

50458056001

INVEGA SUSTENNA 39 MG/0.25 ML

Prescription Drug - Brand

$2,339

—

50458056101

INVEGA SUSTENNA 78 MG/0.5 ML

Prescription Drug - Brand

$2,338

—

50458056201

INVEGA SUSTENNA 117 MG/0.75 ML

Prescription Drug - Brand

$2,340

—

50458056301

INVEGA SUSTENNA 156 MG/ML SYRG

Prescription Drug - Brand

$2,340

—

50458056401

INVEGA SUSTENNA 234 MG/1.5 ML

Prescription Drug - Brand

$2,340

—

50458057501

XARELTO 1 MG/ML SUSPENSION

Prescription Drug - Brand

$4

—

50458057760

XARELTO 2.5 MG TABLET

Prescription Drug - Brand

$10

—

50458057890

XARELTO 15 MG TABLET

Prescription Drug - Brand

$20

—

50458057990

XARELTO 20 MG TABLET

Prescription Drug - Brand

$20

—

50458058090

XARELTO 10 MG TABLET

Prescription Drug - Brand

$20

—

50458058451

XARELTO DVT-PE TREATMENT 30-DAY STARTER 15-20 MG PACK

Prescription Drug - Brand

$20

—

50458058501

CONCERTA ER 18 MG TABLET

Prescription Drug - Brand

$12

—

50458058601

CONCERTA ER 36 MG TABLET

Prescription Drug - Brand

$13

—

50458058701

CONCERTA ER 54 MG TABLET

Prescription Drug - Brand

$14

—

50458058801

CONCERTA ER 27 MG TABLET

Prescription Drug - Brand

$13

—

50458060601

INVEGA TRINZA 273 MG/0.88 ML

Prescription Drug - Brand

$3,989

—

50458060701

INVEGA TRINZA 410 MG/1.32 ML

Prescription Drug - Brand

$3,973

—

50458060801

INVEGA TRINZA 546 MG/1.75 ML

Prescription Drug - Brand

$3,996

—

50458060901

INVEGA TRINZA 819 MG/2.63 ML

Prescription Drug - Brand

$3,981

—

50458061101

INVEGA HAFYERA 1,092 MG/3.5 ML

Prescription Drug - Brand

$4,018

—

50458061201

INVEGA HAFYERA 1,560 MG/5 ML

Prescription Drug - Brand

$4,233

—

50458063965

TOPAMAX 25 MG TABLET

Prescription Drug - Brand

$7

—

50458064065

TOPAMAX 50 MG TABLET

Prescription Drug - Brand

$13

—

50458064165

TOPAMAX 100 MG TABLET

Prescription Drug - Brand

$18

—

50458064265

TOPAMAX 200 MG TABLET

Prescription Drug - Brand

$21

—

50458064565

TOPAMAX 25 MG SPRINKLE CAP

Prescription Drug - Brand

$8

—

50458064765

TOPAMAX 15 MG SPRINKLE CAP

Prescription Drug - Brand

$4

—

50458065060

ULTRACET TABLET

Prescription Drug - Brand

$2

—

50458065330

ULTRAM ER 100 MG TABLET

Prescription Drug - Brand

$7

—

50458065530

ULTRAM ER 200 MG TABLET

Prescription Drug - Brand

$11

—

50458065730

ULTRAM ER 300 MG TABLET

Prescription Drug - Brand

$15

—

50458065960

ULTRAM 50 MG TABLET

Prescription Drug - Brand

$3

—

50458068008

NIZORAL 2% SHAMPOO

Prescription Drug - Brand

$1

—

50458081001

DITROPAN XL 10 MG TABLET

Prescription Drug - Brand

$6

—

50458092050

LEVAQUIN 250 MG TABLET

Prescription Drug - Brand

$25

—

50458092550

LEVAQUIN 500 MG TABLET

Prescription Drug - Brand

$29

—

50458093020

LEVAQUIN 750 MG TABLET

Prescription Drug - Brand

$55

—

50458094001

INVOKAMET XR 50-500 MG TABLET

Prescription Drug - Brand

$10

—

My Cost List