Medical Procedure Costs

00002751017

HUMALOG 100 UNITS/ML VIAL

Prescription Drug - Brand

$26

—

00002751101

HUMALOG MIX 75-25 VIAL

Prescription Drug - Brand

$8

—

00002751201

HUMALOG MIX 50-50 VIAL

Prescription Drug - Brand

$27

—

00002751659

HUMALOG 100 UNIT/ML CARTRIDGE

Prescription Drug - Brand

$10

—

00002771227

HUMALOG 200 UNITS/ML KWIKPEN

Prescription Drug - Brand

$68

—

00002771459

HUMALOG JR 100 UNIT/ML KWIKPEN

Prescription Drug - Brand

$10

—

00002771559

BASAGLAR 100 UNIT/ML KWIKPEN

Prescription Drug - Brand

$21

—

00002772411

TALTZ 80 MG/ML SYRINGE

Prescription Drug - Brand

$7,402

—

00002772801

LYUMJEV 100 UNIT/ML VIAL

Prescription Drug - Brand

$8

—

00002773701

INSULIN LISPRO 100 UNIT/ML VL

Prescription Drug - Generic

$2

—

00002775205

INSULIN LISPRO JR 100 UNIT/ML KWIKPEN

Prescription Drug - Generic

$10

—

00002777211

EBGLYSS 250 MG/2 ML PEN

Prescription Drug - Brand

$1,796

—

00002814801

HUMATROPE 12 MG CARTRIDGE

Prescription Drug - Brand

$1,798

—

00002820705

LYUMJEV 100 UNIT/ML KWIKPEN

Prescription Drug - Brand

$10

—

00002821305

HUMALOG TEMPO PEN 100 UNIT/ML

Prescription Drug - Brand

$10

—

00002821405

BASAGLAR TEMPO PEN 100 UNIT/ML

Prescription Drug - Brand

$21

—

00002821501

HUMULIN R 100 UNITS/ML VIAL

Prescription Drug - Brand

$15

—

00002821591

RELION HUMULIN R 100 UNIT/ML

Prescription Drug - Brand

$11

—

00002822259

INSULIN LISPRO 100 UNIT/ML KWIKPEN

Prescription Drug - Generic

$10

—

00002822827

LYUMJEV 200 UNIT/ML KWIKPEN

Prescription Drug - Brand

$20

—

00002823305

INSULIN LISPRO MIX 75-25 KWKPN

Prescription Drug - Generic

$10

—

00002823505

LYUMJEV TEMPO PEN 100 UNIT/ML

Prescription Drug - Brand

$10

—

00002831501

HUMULIN N 100 UNITS/ML VIAL

Prescription Drug - Brand

$15

—

00002831591

RELION HUMULIN N 100 UNIT/ML

Prescription Drug - Brand

$11

—

00002840001

FORTEO 600 MCG/2.4 ML PEN INJ

Prescription Drug - Brand

$1,726

—

00002850101

HUMULIN R 500 UNITS/ML VIAL

Prescription Drug - Brand

$71

—

00002871501

HUMULIN 70-30 VIAL

Prescription Drug - Brand

$4

—

00002871591

RELION HUMULIN 70-30 VIAL

Prescription Drug - Brand

$11

—

00002873059

HUMULIN N 100 UNITS/ML PEN

Prescription Drug - Brand

$25

—

00002877059

HUMULIN 70-30 PEN

Prescription Drug - Brand

$25

—

00002879759

HUMALOG MIX 75-25 KWIKPEN

Prescription Drug - Brand

$10

—

00002879859

HUMALOG MIX 50-50 KWIKPEN

Prescription Drug - Brand

$10

—

00002879959

HUMALOG 100 UNIT/ML KWIKPEN

Prescription Drug - Brand

$10

—

00002880359

HUMULIN 70/30 KWIKPEN

Prescription Drug - Brand

$9

—

00002880559

HUMULIN N 100 UNIT/ML KWIKPEN

Prescription Drug - Brand

$9

—

00002882427

HUMULIN R 500 UNITS/ML KWIKPEN

Prescription Drug - Brand

$92

—

00002898005

REZVOGLAR 100 UNIT/ML KWIKPEN

Prescription Drug - Brand

$6

—

00002967801

FORTEO 560 MCG/2.24 ML PEN INJ

Prescription Drug - Brand

$1,840

—

00003005060

COBENFY 50 MG-20 MG CAPSULE

Prescription Drug - Brand

$30

—

00003012560

COBENFY 125 MG-30 MG CAPSULE

Prescription Drug - Brand

$30

—

00003021501

DAKLINZA 60 MG TABLET

Prescription Drug - Brand

$732

—

00003029305

KENALOG-40 40 MG/ML VIAL

Prescription Drug - Brand

$9

—

00003029320

KENALOG-40 200 MG/5 ML VIAL

Prescription Drug - Brand

$9

—

00003029328

KENALOG-40 400 MG/10 ML VIAL

Prescription Drug - Brand

$7

—

00003031505

KENALOG-80 80 MG/ML VIAL

Prescription Drug - Brand

$18

—

00003049420

KENALOG-10 50 MG/5 ML VIAL

Prescription Drug - Brand

$2

—

00003052811

SPRYCEL 50 MG TABLET

Prescription Drug - Brand

$327

—

00003085222

SPRYCEL 100 MG TABLET

Prescription Drug - Brand

$590

—

00003089331

ELIQUIS 2.5 MG TABLET

Prescription Drug - Brand

$6

—

00003089470

ELIQUIS 5 MG TABLET

Prescription Drug - Brand

$6

—

My Cost List