Medical Procedure Costs

00093360982

FLUTICASONE-SALMETEROL 232-14

Prescription Drug - Generic

$107

—

00093372755

DICLOFENAC EPOLAMINE 1.3% PTCH

Prescription Drug - Generic

$5

—

00093405953

CEFADROXIL 1 GM TABLET

Prescription Drug - Generic

$4

—

00093412573

PENICILLIN VK 125 MG/5 ML SOLN

Prescription Drug - Generic

$0

—

00093412774

PENICILLIN VK 250 MG/5 ML SOLN

Prescription Drug - Generic

$0

—

00093517355

NIFEDICAL XL 60 MG TABLET

Prescription Drug - Generic

$0

—

00093527255

NIFEDIAC CC 30 MG TABLET

Prescription Drug - Generic

$0

—

00093532862

JUNEL FE 24 TABLET

Prescription Drug - Generic

$0

—

00093534601

METHYLPHENIDATE ER 20 MG CAP

Prescription Drug - Generic

$4

—

00093535156

BUDEPRION XL 300 MG TABLET

Prescription Drug - Generic

$1

—

00093542362

GIANVI 3 MG-0.02 MG TABLET

Prescription Drug - Generic

$0

—

00093545428

MIMVEY LO 0.5-0.1 MG TABLET

Prescription Drug - Generic

$2

—

00093545542

MIMVEY 1-0.5 MG TABLET

Prescription Drug - Generic

$1

—

00093550101

BUDEPRION SR 100 MG TABLET

Prescription Drug - Generic

$0

—

00093550201

BUDEPRION SR 150 MG TABLET

Prescription Drug - Generic

$0

—

00093570301

BUPROBAN 150 MG TABLET

Prescription Drug - Generic

$0

—

00093603191

RIVELSA TABLET

Prescription Drug - Generic

$1

—

00093613732

DIAZEPAM 2.5 MG RECTAL GEL

Prescription Drug - Generic

$215

—

00093613832

DIAZEPAM 10 MG RECTAL GEL

Prescription Drug - Generic

$279

—

00093613932

DIAZEPAM 20 MG RECTAL GEL

Prescription Drug - Generic

$269

—

00093614891

CAMRESE LO TABLET

Prescription Drug - Generic

$0

—

00093711306

NEFAZODONE HCL 150 MG TABLET

Prescription Drug - Generic

$1

—

00093717801

NEFAZODONE HCL 50 MG TABLET

Prescription Drug - Generic

$1

—

00093723281

RIBAVIRIN 200 MG TABLET

Prescription Drug - Generic

$1

—

00093803401

GLYBURIDE MICRO 1.5 MG TAB

Prescription Drug - Generic

$0

—

00093803505

GLYBURIDE MICRO 3 MG TABLET

Prescription Drug - Generic

$0

—

00093803601

GLYBURIDE MICRO 6 MG TABLET

Prescription Drug - Generic

$0

—

00093807328

KELNOR 1-50 TABLET

Prescription Drug - Generic

$1

—

00093821062

FINZALA 1-0.02(24)-75 CHEW TAB

Prescription Drug - Generic

$0

—

00095004950

CORMAX 0.05% SOLUTION

Prescription Drug - Generic

$2

—

00095008735

DEXPAK 10 DAY 1.5 MG TABLET

Prescription Drug - Generic

$8

—

00095008851

DEXPAK 13 DAY 1.5 MG TABLET

Prescription Drug - Generic

$2

—

00095008921

DEXPAK 6 DAY 1.5 MG TABLET

Prescription Drug - Generic

$7

—

00095067416

ZOLVIT 10 MG-300 MG/15 ML SOLUTION

Prescription Drug - Brand

$0

—

00095086006

LODRANE D CAPSULE

Prescription Drug - Generic

$1

—

00095095005

ZOLPIMIST 5 MG ORAL SPRAY

Prescription Drug - Brand

$14

—

00095300001

BUPAP 50 MG-300 MG TABLET

Prescription Drug - Generic

$3

—

00095702901

ORBIVAN CAPSULE

Prescription Drug - Brand

$2

—

00096070760

DRYSOL SOLUTION

Prescription Drug - Generic

$0

—

00096070960

XERAC AC 6.25% SOLUTION

Prescription Drug - Generic

$0

—

00096072004

DML FORTE CREAM W-PANTHENOL

Prescription Drug - Generic

$0

—

00096072145

DML FACIAL MOISTURIZER CRM

Prescription Drug - Generic

$0

—

00096072216

DML LOTION

Prescription Drug - Generic

$0

—

00096072416

AQUANIL CLEANSER

Prescription Drug - Generic

$0

—

00096073204

AQUANIL HC 1% LOTION

Prescription Drug - Generic

$0

—

00096073516

DHS ZINC 2% SHAMPOO

Prescription Drug - Brand

$0

—

00096073608

DHS TAR GEL 0.5% SHAMPOO

Prescription Drug - Brand

$0

—

00096073708

DHS TAR 0.5% SHAMPOO

Prescription Drug - Brand

$0

—

00096073804

DHS SAL 3% SHAMPOO

Prescription Drug - Brand

$0

—

0009U

Gene analysis of breast tumor tissue

Pathology/Laboratory

$107

—

My Cost List