Medical Procedure Costs

52747071130

INTEGRA F CAPSULE

Prescription Drug - Brand

$1

—

52747071230

INTEGRA PLUS CAPSULE

Prescription Drug - Brand

$1

—

52747080060

HEMOCYTE PLUS CAPSULE

Prescription Drug - Brand

$1

—

52747090090

TANDEM DUAL ACTION CAPSULE

Prescription Drug - Brand

$0

—

52817011710

PRIMIDONE 125 MG TABLET

Prescription Drug - Generic

$1

—

52817026830

BISOPROLOL FUMARATE 2.5 MG TAB

Prescription Drug - Generic

$3

—

52817037530

CLONIDINE HCL ER 0.17 MG TAB

Prescription Drug - Generic

$15

—

52817038510

GLIPIZIDE 2.5 MG TABLET

Prescription Drug - Generic

$1

—

52817081701

HYDROCORT-PRAMOXINE 2.5-1% CRM

Prescription Drug - Generic

$2

—

52817083530

NITROGLYCERIN 0.4% OINTMENT

Prescription Drug - Generic

$10

—

52937000120

VASCEPA 1 GM CAPSULE

Prescription Drug - Brand

$3

—

52937000340

VASCEPA 0.5 GM CAPSULE

Prescription Drug - Brand

$2

—

53000

Incision of urethra

Surgery - Urinary

$139

—

53010

Incision of urethra

Surgery - Urinary

$281

—

53014040410

SEMPREX-D 60 MG/8 MG CAPSULE

Prescription Drug - Brand

$3

—

53014054801

TUSSIONEX PENNKINETIC SUSP

Prescription Drug - Brand

$1

—

53014057907

METADATE CD 10 MG CAPSULE

Prescription Drug - Brand

$7

—

53014058007

METADATE CD 20 MG CAPSULE

Prescription Drug - Brand

$7

—

53014058107

METADATE CD 30 MG CAPSULE

Prescription Drug - Brand

$7

—

53014058207

METADATE CD 40 MG CAPSULE

Prescription Drug - Brand

$10

—

53014058307

METADATE CD 50 MG CAPSULE

Prescription Drug - Brand

$12

—

53014058407

METADATE CD 60 MG CAPSULE

Prescription Drug - Brand

$12

—

53020

Incision of urethra

Surgery - Urinary

$86

—

53025

Incision of urethra

Surgery - Urinary

$63

—

53040

Drainage of urethra abscess

Surgery - Urinary

$362

—

53060

Drainage of urethra abscess

Surgery - Urinary

$149

—

53080

Drainage of urinary leakage

Surgery - Urinary

$389

—

53085

Drainage of urinary leakage

Surgery - Urinary

$591

—

53200

Biopsy of urethra

Surgery - Urinary

$128

—

53210

Removal of urethra

Surgery - Urinary

$696

—

53215

Removal of urethra

Surgery - Urinary

$833

—

53220

Treatment of urethra lesion

Surgery - Urinary

$416

—

53230

Removal of urethra lesion

Surgery - Urinary

$554

—

53235

Removal of urethra lesion

Surgery - Urinary

$578

—

53240

Surgery for urethra pouch

Surgery - Urinary

$392

—

53250

Removal of urethra gland

Surgery - Urinary

$367

—

53260

Treatment of urethra lesion

Surgery - Urinary

$166

—

53265

Treatment of urethra lesion

Surgery - Urinary

$170

—

53270

Removal of urethra gland

Surgery - Urinary

$169

—

53275

Repair of urethra defect

Surgery - Urinary

$238

—

53329016104

REMEDY SKIN REPAIR CREAM

Prescription Drug - Brand

$0

—

53329016444

REMEDY CALAZIME PROTECT PASTE

Prescription Drug - Brand

$0

—

53400

Revise urethra stage 1

Surgery - Urinary

$724

—

53405

Revise urethra stage 2

Surgery - Urinary

$787

—

53410

Reconstruction of urethra

Surgery - Urinary

$879

—

53415

Reconstruction of urethra

Surgery - Urinary

$1,011

—

53420

Reconstruct urethra stage 1

Surgery - Urinary

$758

—

53425

Reconstruct urethra stage 2

Surgery - Urinary

$840

—

53430

Reconstruction of urethra

Surgery - Urinary

$873

—

53431

Reconstruct urethra/bladder

Surgery - Urinary

$1,030

—

My Cost List