Medical Procedure Costs

62135047660

DANAZOL 100 MG CAPSULE

Prescription Drug - Generic

$2

—

62135047760

DANAZOL 200 MG CAPSULE

Prescription Drug - Generic

$3

—

62135048890

DIETHYLPROPION 25 MG TABLET

Prescription Drug - Generic

$0

—

62135048930

DIETHYLPROPION ER 75 MG TABLET

Prescription Drug - Generic

$2

—

62135049190

LETROZOLE 2.5 MG TABLET

Prescription Drug - Generic

$0

—

62135049430

GRISEOFULVIN ULTRA 125 MG TAB

Prescription Drug - Generic

$3

—

62135049530

GRISEOFULVIN ULTRA 250 MG TAB

Prescription Drug - Generic

$3

—

62135049630

GRISEOFULVIN MICRO 500 MG TAB

Prescription Drug - Generic

$6

—

62135052047

OXYBUTYNIN 5 MG/5 ML SOLUTION

Prescription Drug - Generic

$0

—

62135055647

THEOPHYLLINE 80 MG/15 ML SOLN

Prescription Drug - Generic

$0

—

62135057312

HYDROXYZINE HCL 10 MG TABLET

Prescription Drug - Generic

$0

—

62135057512

HYDROXYZINE HCL 50 MG TABLET

Prescription Drug - Generic

$0

—

62135058690

ISOSORBIDE MONONIT ER 30 MG TB

Prescription Drug - Generic

$0

—

62135058790

ISOSORBIDE MONONIT ER 60 MG TB

Prescription Drug - Generic

$0

—

62135058890

ISOSORBIDE MONONIT ER 120 MG

Prescription Drug - Generic

$0

—

62135064947

CHLORHEXIDINE 0.12% RINSE

Prescription Drug - Generic

$0

—

62135074190

NYSTATIN 500,000 UNIT ORAL TAB

Prescription Drug - Generic

$0

—

62135074390

VERAPAMIL 40 MG TABLET

Prescription Drug - Generic

$0

—

62135074490

VERAPAMIL 80 MG TABLET

Prescription Drug - Generic

$0

—

62135074590

VERAPAMIL 120 MG TABLET

Prescription Drug - Generic

$0

—

62135075047

HYDROXYZINE 10 MG/5 ML SYRUP

Prescription Drug - Generic

$0

—

62135076843

DIAZEPAM 25 MG/5 ML ORAL CONC

Prescription Drug - Generic

$1

—

62135078690

DIAZEPAM 2 MG TABLET

Prescription Drug - Generic

$0

—

62135078790

DIAZEPAM 5 MG TABLET

Prescription Drug - Generic

$0

—

62135078890

DIAZEPAM 10 MG TABLET

Prescription Drug - Generic

$0

—

62135080151

ACETIC ACID 2% EAR SOLUTION

Prescription Drug - Generic

$1

—

62135080937

CIMETIDINE 300 MG/5 ML SOLN

Prescription Drug - Generic

$1

—

62135081612

HYDROXYZINE PAM 25 MG CAP

Prescription Drug - Generic

$0

—

62135081712

HYDROXYZINE PAM 50 MG CAP

Prescription Drug - Generic

$0

—

62135088360

CLARITHROMYCIN ER 500 MG TAB

Prescription Drug - Generic

$3

—

62135089247

GENERLAC 10 GM/15 ML SOLUTION

Prescription Drug - Generic

$0

—

62135091738

LEVOCETIRIZINE 2.5 MG/5 ML SOL

Prescription Drug - Generic

$0

—

62135094337

MEMANTINE HCL 2 MG/ML SOLUTION

Prescription Drug - Generic

$1

—

62135095990

PHENTERMINE 8 MG TABLET

Prescription Drug - Generic

$1

—

62135096031

SULFASALAZINE 500 MG TABLET

Prescription Drug - Generic

$0

—

62135097325

MEFLOQUINE HCL 250 MG TABLET

Prescription Drug - Generic

$4

—

62140

Crnop skull defect<5 cm diam

Surgery - Nervous

$979

—

62141

Crnop skull defect>5 cm diam

Surgery - Nervous

$1,116

—

62142

Rmvl b1 flp/prostc plate skl

Surgery - Nervous

$901

—

62143

Rpl b1 flp/prostc plate skl

Surgery - Nervous

$1,043

—

62145

Repair of skull & brain

Surgery - Nervous

$1,366

—

62146

Crnop w/autograft<5 cm diam

Surgery - Nervous

$1,243

—

62147

Crnop w/autograft>5 cm diam

Surgery - Nervous

$1,362

—

62148

Retr bone flap to fix skull

Surgery - Nervous

$115

—

62160

Neuroendoscopy add-on

Surgery - Nervous

$172

—

62161

Dissect brain w/scope

Surgery - Nervous

$1,503

—

62162

Remove colloid cyst w/scope

Surgery - Nervous

$1,853

—

62164

Remove brain tumor w/scope

Surgery - Nervous

$2,060

—

62165

Remove pituit tumor w/scope

Surgery - Nervous

$1,401

—

62175019007

GLYCOLAX POWDER

Prescription Drug - Generic

$0

—

My Cost List