Medical Procedure Costs

61880

Revise/remove neuroelectrode

Surgery - Nervous

$620

—

61885

Insrt/redo neurostim 1 array

Surgery - Nervous

$557

—

61886

Implant neurostim arrays

Surgery - Nervous

$931

—

61888

Revise/remove neuroreceiver

Surgery - Nervous

$403

—

61889

Ins sk-mnt crnl nstm pg/rcvr

Surgery - Nervous

$1,750

—

61891

Rev/rplcmt sk-mnt crnl nstm

Surgery - Nervous

$837

—

61892

Rmv sk-mnt crnl nstm pg/rcvr

Surgery - Nervous

$1,096

—

61958040101

VIREAD 300 MG TABLET

Prescription Drug - Brand

$41

—

61958050101

HEPSERA 10 MG TABLET

Prescription Drug - Brand

$40

—

61958060101

EMTRIVA 200 MG CAPSULE

Prescription Drug - Brand

$17

—

61958070101

TRUVADA 200 MG-300 MG TABLET

Prescription Drug - Brand

$60

—

61958100301

RANEXA ER 500 MG TABLET

Prescription Drug - Brand

$7

—

61958100401

RANEXA ER 1,000 MG TABLET

Prescription Drug - Brand

$11

—

61958110101

COMPLERA TABLET

Prescription Drug - Brand

$131

—

61958120101

STRIBILD TABLET

Prescription Drug - Brand

$150

—

61958150101

SOVALDI 400 MG TABLET

Prescription Drug - Brand

$982

—

61958180101

HARVONI 90-400 MG TABLET

Prescription Drug - Brand

$1,099

—

61958190101

GENVOYA TABLET

Prescription Drug - Brand

$143

—

61958200202

DESCOVY 200-25 MG TABLET

Prescription Drug - Brand

$71

—

61958200501

DESCOVY 120-15 MG TABLET

Prescription Drug - Brand

$71

—

61958210101

ODEFSEY TABLET

Prescription Drug - Brand

$130

—

61958220101

EPCLUSA 400 MG-100 MG TABLET

Prescription Drug - Brand

$867

—

61958230101

VEMLIDY 25 MG TABLET

Prescription Drug - Brand

$52

—

61958250103

BIKTARVY 50-200-25 MG TABLET

Prescription Drug - Brand

$137

—

61958250601

BIKTARVY 30-120-15 MG TABLET

Prescription Drug - Brand

$137

—

62000

Treat skull fracture

Surgery - Nervous

$1,041

—

62005

Treat skull fracture

Surgery - Nervous

$1,264

—

62010

Treatment of head injury

Surgery - Nervous

$1,518

—

62011000101

HM INFNT PAIN & FEVER 160 MG/5

Prescription Drug - Generic

$0

—

62011001201

HM INF IBUPROFEN 50 MG/1.25 ML

Prescription Drug - Generic

$0

—

62011001401

HM IBUPROFEN 200 MG TABLET

Prescription Drug - Generic

$0

—

62011001502

HM IBUPROFEN 200 MG CAPLET

Prescription Drug - Generic

$0

—

62011001601

HM IBUPROFEN 200 MG CAPSULE

Prescription Drug - Generic

$0

—

62011001701

HM NAPROXEN SOD 220 MG CAPLET

Prescription Drug - Generic

$0

—

62011001901

HM LOW DOSE ASPIRIN EC 81 MG

Prescription Drug - Generic

$0

—

62011002303

HM PAIN RELIEF 500 MG CAPLET

Prescription Drug - Generic

$0

—

62011002601

HM ARTHRITIS PAIN ER 650 MG

Prescription Drug - Generic

$0

—

62011002801

HM ASPIRIN 81 MG CHEWABLE TAB

Prescription Drug - Generic

$0

—

62011003001

HM CHLD IBUPROFEN 100 MG/5 ML

Prescription Drug - Generic

$0

—

62011003201

HM PAIN RELIEVER 325 MG TABLET

Prescription Drug - Generic

$0

—

62011003202

HM PAIN RELIEF 325 MG TABLET

Prescription Drug - Generic

$0

—

62011004501

HM ALCOHOL 70% PREP PADS

Prescription Drug - Generic

$0

—

62011004702

HM NICOTINE 2 MG CHEWING GUM

Prescription Drug - Generic

$0

—

62011004901

HM PAIN RELIEVER 500 MG TABLET

Prescription Drug - Generic

$0

—

62011005301

HM FIBER 0.52 GRAM CAPSULE

Prescription Drug - Generic

$0

—

62011005401

HM CHLD ALLER COMPLETE 1 MG/ML

Prescription Drug - Generic

$0

—

62011005601

HM ALLERGY 25 MG CAPSULE

Prescription Drug - Generic

$0

—

62011005801

HM ALLERGY 25 MG TABLET

Prescription Drug - Generic

$0

—

62011006001

HM CHEST CONGEST RLF 400 MG TB

Prescription Drug - Generic

$0

—

62011006101

HM CHEST CONGEST RLF DM CAPLET

Prescription Drug - Generic

$0

—

My Cost List