Medical Procedure Costs

62355

Remove spinal canal catheter

Surgery - Nervous

$281

—

62360

Insert spine infusion device

Surgery - Nervous

$311

—

62361

Implant spine infusion pump

Surgery - Nervous

$465

—

62362

Implant spine infusion pump

Surgery - Nervous

$372

—

62365

Remove spine infusion device

Surgery - Nervous

$296

—

62367

Analyze spine infus pump

Surgery - Nervous

$21

—

62368

Analyze sp inf pump w/reprog

Surgery - Nervous

$29

—

62369

Anal sp inf pmp w/reprg&fill

Surgery - Nervous

$30

—

62370

Anl sp inf pmp w/mdreprg&fil

Surgery - Nervous

$39

—

62484001505

XROMI 100 MG/ML SOLUTION

Prescription Drug - Brand

$5

—

62541020130

QSYMIA 3.75 MG-23 MG CAPSULE

Prescription Drug - Brand

$6

—

62541020230

QSYMIA 7.5 MG-46 MG CAPSULE

Prescription Drug - Brand

$6

—

62541020330

QSYMIA 11.25 MG-69 MG CAPSULE

Prescription Drug - Brand

$6

—

62541020430

QSYMIA 15 MG-92 MG CAPSULE

Prescription Drug - Brand

$6

—

62541030230

STENDRA 100 MG TABLET

Prescription Drug - Brand

$60

—

62541030330

STENDRA 200 MG TABLET

Prescription Drug - Brand

$60

—

62542001030

AMPHETAMINE ER 6.3 MG ODT

Prescription Drug - Generic

$16

—

62542001530

AMPHETAMINE ER 9.4 MG ODT

Prescription Drug - Generic

$16

—

62542002030

AMPHETAMINE ER 12.5 MG ODT

Prescription Drug - Generic

$17

—

62542002530

AMPHETAMINE ER 15.7 MG ODT

Prescription Drug - Generic

$17

—

62542003030

AMPHETAMINE ER 18.8 MG ODT

Prescription Drug - Generic

$16

—

62542010105

CARBINOXAMINE ER 4 MG/5 ML SUSP

Prescription Drug - Generic

$1

—

62559013807

HYDROCORTISONE 100 MG/60 ML

Prescription Drug - Generic

$0

—

62559015230

OXYCODONE HCL 100 MG/5 ML SOLN

Prescription Drug - Generic

$3

—

62559015304

OPIUM TINCTURE 10 MG/ML

Prescription Drug - Generic

$3

—

62559016701

OXYCODONE HCL (IR) 5 MG CAP

Prescription Drug - Generic

$0

—

62559020412

BACLOFEN 25 MG/5 ML SUSPENSION

Prescription Drug - Generic

$4

—

62559025001

ETODOLAC 200 MG CAPSULE

Prescription Drug - Generic

$0

—

62559025101

ETODOLAC 300 MG CAPSULE

Prescription Drug - Generic

$0

—

62559025501

ACEBUTOLOL 200 MG CAPSULE

Prescription Drug - Generic

$1

—

62559025601

ACEBUTOLOL 400 MG CAPSULE

Prescription Drug - Generic

$1

—

62559028001

LITHOBID ER 300 MG TABLET

Prescription Drug - Brand

$12

—

62559028560

OXISTAT 1% LOTION

Prescription Drug - Brand

$11

—

62559028860

FLUOCINOLONE 0.01% CREAM

Prescription Drug - Generic

$1

—

62559028960

FLUOCINOLONE 0.025% CREAM

Prescription Drug - Generic

$1

—

62559029960

FLUOCINOLONE 0.025% OINTMENT

Prescription Drug - Generic

$1

—

62559035601

KIONEX 15 GM/60 ML SUSPENSION

Prescription Drug - Brand

$0

—

62559038530

VEREGEN 15% OINTMENT

Prescription Drug - Brand

$52

—

62559039050

VANCOMYCIN HCL 125 MG CAPSULE

Prescription Drug - Generic

$1

—

62559039150

VANCOMYCIN HCL 250 MG CAPSULE

Prescription Drug - Generic

$3

—

62559042007

MESALAMINE 4 GM/60 ML ENEMA

Prescription Drug - Generic

$0

—

62559042101

HYOSCYAMINE SULF 0.125 MG TAB

Prescription Drug - Generic

$0

—

62559042201

HYOSCYAMINE 0.125 MG ODT

Prescription Drug - Generic

$0

—

62559042301

HYOSCYAMINE ER 0.375 MG TAB

Prescription Drug - Generic

$1

—

62559042401

HYOSCYAMINE 0.125 MG TAB SL

Prescription Drug - Generic

$0

—

62559043130

HYDROCORTISONE 2.5% CREAM

Prescription Drug - Generic

$0

—

62559046090

FENOFIBRATE 50 MG CAPSULE

Prescription Drug - Generic

$3

—

62559046190

FENOFIBRATE 150 MG CAPSULE

Prescription Drug - Generic

$5

—

62559051001

INDAPAMIDE 1.25 MG TABLET

Prescription Drug - Generic

$0

—

62559051101

INDAPAMIDE 2.5 MG TABLET

Prescription Drug - Generic

$0

—

My Cost List