Medical Procedure Costs

0010U

Typing of bacterial strain

Pathology/Laboratory

$427

—

00113000972

GS CAL ANTACID 750 MG CHEW TAB

Prescription Drug - Generic

$0

—

00113002809

GS 24 HOUR ALLERGY 50 MCG SPRY

Prescription Drug - Generic

$1

—

00113003263

GS DUAL ACTION COMPLETE TB CHW

Prescription Drug - Generic

$0

—

00113004278

GS ALLERGY RELIEF 4 MG TABLET

Prescription Drug - Generic

$0

—

00113004771

ACID REDUCER 150 MG TABLET

Prescription Drug - Generic

$0

—

00113005060

GS IBUPROFEN PM CAPLET

Prescription Drug - Generic

$0

—

00113005253

GS SLEEP TIME 25 MG SOFTGEL

Prescription Drug - Generic

$0

—

00113005452

GS SUPHEDRINE 12HR 120 MG CPLT

Prescription Drug - Generic

$0

—

00113005673

GS NIGHTTIME COLD-FLU SOFTGEL

Prescription Drug - Generic

$0

—

00113005705

GS INF IBUPROFEN 50 MG/1.25 ML

Prescription Drug - Generic

$0

—

00113006126

GS TUSSIN MUCUS-CONG 200 MG/10

Prescription Drug - Generic

$0

—

00113006134

TUSSIN MUCUS-CONGEST 100 MG/5

Prescription Drug - Generic

$0

—

00113008100

GS MICONAZOLE 3 COMBO PACK

Prescription Drug - Generic

$8

—

00113008464

GS FIRST AID ANTIBIOTIC OINT

Prescription Drug - Generic

$0

—

00113008762

GS ANTI-DIARRHEAL-ANTIGAS CPLT

Prescription Drug - Generic

$0

—

00113009489

GS NASAL DECONG PE 10 MG TAB

Prescription Drug - Generic

$0

—

00113009691

GS FLU-SEV COLD-COUGH DAY PKT

Prescription Drug - Generic

$1

—

00113011226

GS NAUSEA RELIEF LIQUID

Prescription Drug - Generic

$0

—

00113014165

GS ACID REDUCER 10 MG TABLET

Prescription Drug - Generic

$0

—

00113014762

GS ALL DAY ALLERGY-D TABLET

Prescription Drug - Generic

$1

—

00113016522

ALLERGY-CONGESTION RELF ER TAB

Prescription Drug - Generic

$0

—

00113016552

ALLERGY-CONGEST RELIEF ER TAB

Prescription Drug - Generic

$0

—

00113018640

GS SLEEP TIME 50 MG/30 ML LIQ

Prescription Drug - Generic

$0

—

00113018816

GS HEMORRHOIDAL OINTMENT

Prescription Drug - Generic

$0

—

00113019471

GS ACID REDUCER 20 MG TABLET

Prescription Drug - Generic

$0

—

00113022491

GS ANTI-DIARRHEAL 2 MG CAPLET

Prescription Drug - Generic

$0

—

00113022771

GS PAIN RELIEF 500 MG TABLET

Prescription Drug - Generic

$0

—

00113023462

COLD HEAD CONGESTION CAPLET

Prescription Drug - Generic

$0

—

00113027262

GS SINUS CONGESTION-PAIN CPLT

Prescription Drug - Generic

$0

—

00113027953

GS HEMORRHOIDAL SUPPOSITORIES

Prescription Drug - Generic

$0

—

00113029858

GS IBUPROFEN 200 MG LIQUID GEL

Prescription Drug - Generic

$0

—

00113030234

GS STOMACH RELIEF 525 MG/30 ML

Prescription Drug - Generic

$0

—

00113030410

GS NASAL SPRAY 0.05%

Prescription Drug - Generic

$0

—

00113030603

GS CLEARLAX POWDER

Prescription Drug - Generic

$0

—

00113030652

CLEARLAX PACKET

Prescription Drug - Generic

$1

—

00113030862

MULTI-SYMPTOM COLD CAPLET

Prescription Drug - Generic

$0

—

00113032365

GS LUBRICAT PLUS 0.5% EYE DRPS

Prescription Drug - Generic

$0

—

00113033534

GS NIGHTTIME COLD & FLU LIQUID

Prescription Drug - Generic

$0

—

00113034040

ANTACID-SIMETHICONE LIQUID

Prescription Drug - Generic

$0

—

00113034405

GS NICOTINE 2 MG LOZENGE

Prescription Drug - Generic

$0

—

00113035571

HEADACHE PM 25-500 MG TABLET

Prescription Drug - Generic

$0

—

00113035740

GS ANTACID PLUS ANTI-GAS LIQ

Prescription Drug - Generic

$0

—

00113035926

TUSSIN DM COUGH SYRUP

Prescription Drug - Generic

$0

—

00113035934

TUSSIN DM COUGH & CHEST LIQUID

Prescription Drug - Generic

$0

—

00113037162

COLD MULTI-SYMPTOM CAPLET

Prescription Drug - Generic

$0

—

00113037462

GS MIGRAINE FORMULA CAPLET

Prescription Drug - Generic

$0

—

00113037478

GS MIGRAINE 250-250-65 MG CPLT

Prescription Drug - Generic

$0

—

00113037926

GS CHILD ALLERGY 12.5 MG/5 ML

Prescription Drug - Generic

$0

—

00113038428

GS COUGH DM ER 30 MG/5 ML SUSP

Prescription Drug - Generic

$0

—

My Cost List