Medical Procedure Costs

52427028601

MACRODANTIN 25 MG CAPSULE

Prescription Drug - Brand

$11

—

52427042990

TENORMIN 25 MG TABLET

Prescription Drug - Brand

$13

—

52427043090

TENORMIN 50 MG TABLET

Prescription Drug - Brand

$13

—

52427044090

ZESTRIL 10 MG TABLET

Prescription Drug - Brand

$13

—

52427057530

FORFIVO XL 450 MG TABLET

Prescription Drug - Brand

$15

—

52427063230

VENLAFAXINE BES ER 112.5 MG TB

Prescription Drug - Generic

$6

—

52427065830

LOREEV XR 1 MG CAPSULE

Prescription Drug - Brand

$14

—

52427066130

LOREEV XR 1.5 MG CAPSULE

Prescription Drug - Brand

$14

—

52427066330

LOREEV XR 2 MG CAPSULE

Prescription Drug - Brand

$14

—

52427066730

LOREEV XR 3 MG CAPSULE

Prescription Drug - Brand

$14

—

52427069130

CITALOPRAM HBR 30 MG CAPSULE

Prescription Drug - Generic

$5

—

52427077530

ZOLPIDEM TARTRATE 7.5 MG CAP

Prescription Drug - Generic

$8

—

52427079530

ESCITALOPRAM 15 MG CAPSULE

Prescription Drug - Generic

$5

—

52427080390

GRALISE ER 300 MG TABLET

Prescription Drug - Brand

$10

—

52427080460

GRALISE ER 450 MG TABLET

Prescription Drug - Brand

$10

—

52427080690

GRALISE ER 600 MG TABLET

Prescription Drug - Brand

$10

—

52427085060

GRALISE ER 750 MG TABLET

Prescription Drug - Brand

$15

—

52427089060

GRALISE ER 900 MG TABLET

Prescription Drug - Brand

$15

—

52441

Cysto insj trnsprstc 1 implt

Surgery - Urinary

$184

—

52442

Cysto ins trnsprstc implt ea

Surgery - Urinary

$44

—

52443

Cysto 1st trurl prst8 comis

Surgery - Urinary

$172

—

52450

Transurethral inc prostate

Surgery - Urinary

$438

—

52500

Trurl resection bladder neck

Surgery - Urinary

$352

—

52536050003

DEXTROAMPHETAMINE 5 MG TAB

Prescription Drug - Generic

$0

—

52536088001

VERAPAMIL SR 120 MG CAPSULE

Prescription Drug - Generic

$2

—

52536088201

VERAPAMIL SR 180 MG CAPSULE

Prescription Drug - Generic

$2

—

52536088401

VERAPAMIL SR 240 MG CAPSULE

Prescription Drug - Generic

$3

—

52536088601

VERAPAMIL SR 360 MG CAPSULE

Prescription Drug - Generic

$8

—

52544001160

KADIAN ER 10 MG CAPSULE

Prescription Drug - Brand

$9

—

52544003260

KADIAN ER 30 MG CAPSULE

Prescription Drug - Brand

$11

—

52544003960

KADIAN ER 40 MG CAPSULE

Prescription Drug - Brand

$15

—

52544004154

GELNIQUE 3% GEL

Prescription Drug - Brand

$3

—

52544005260

KADIAN ER 50 MG CAPSULE

Prescription Drug - Brand

$19

—

52544006360

KADIAN ER 60 MG CAPSULE

Prescription Drug - Brand

$22

—

52544006431

LAYOLIS FE CHEWABLE TABLET

Prescription Drug - Generic

$2

—

52544006554

NEXT CHOICE ONE DOSE 1.5 MG TB

Prescription Drug - Generic

$15

—

52544007960

PREQUE 10 TABLET

Prescription Drug - Brand

$2

—

52544008001

FIORICET 50-300-40 MG CAPSULE

Prescription Drug - Brand

$9

—

52544008430

GELNIQUE 10% GEL SACHETS

Prescription Drug - Brand

$13

—

52544008741

TRINESSA LO TABLET

Prescription Drug - Generic

$0

—

52544016201

NORCO 7.5-325 TABLET

Prescription Drug - Brand

$3

—

52544016460

KADIAN ER 100 MG CAPSULE

Prescription Drug - Brand

$37

—

52544016528

NECON 7-7-7-28 TABLET

Prescription Drug - Generic

$1

—

52544020431

GENERESS FE CHEWABLE TABLET

Prescription Drug - Brand

$6

—

52544021160

KADIAN ER 20 MG CAPSULE

Prescription Drug - Brand

$10

—

52544023631

JEVANTIQUE LO 0.5 MG-2.5 MCG

Prescription Drug - Generic

$3

—

52544024531

NECON 1-50-28 TABLET

Prescription Drug - Generic

$1

—

52544024728

MONONESSA 28 TABLET

Prescription Drug - Generic

$0

—

52544024828

TRINESSA TABLET

Prescription Drug - Generic

$0

—

52544027536

NEXT CHOICE 0.75 MG TABLET

Prescription Drug - Generic

$14

—

My Cost List