Medical Procedure Costs

62559059030

INNOPRAN XL 80 MG CAPSULE

Prescription Drug - Brand

$69

—

62559059130

INNOPRAN XL 120 MG CAPSULE

Prescription Drug - Brand

$69

—

62559060030

INDERAL XL 80 MG CAPSULE

Prescription Drug - Brand

$69

—

62559060130

INDERAL XL 120 MG CAPSULE

Prescription Drug - Brand

$69

—

62559064130

ATACAND 8 MG TABLET

Prescription Drug - Brand

$7

—

62559064290

ATACAND 16 MG TABLET

Prescription Drug - Brand

$8

—

62559064390

ATACAND 32 MG TABLET

Prescription Drug - Brand

$10

—

62559066090

CANDESARTAN-HYDROCHLOROTHIAZIDE 16-12.5 MG TB

Prescription Drug - Generic

$1

—

62559066190

CANDESARTAN-HYDROCHLOROTHIAZIDE 32-12.5 MG TB

Prescription Drug - Generic

$1

—

62559066290

CANDESARTAN-HYDROCHLOROTHIAZIDE 32-25 MG TAB

Prescription Drug - Generic

$1

—

62559067030

ARIMIDEX 1 MG TABLET

Prescription Drug - Brand

$53

—

62559072101

TERBUTALINE SULFATE 2.5 MG TAB

Prescription Drug - Generic

$1

—

62559072201

TERBUTALINE SULFATE 5 MG TAB

Prescription Drug - Generic

$1

—

62756001740

TESTOSTERON CYP 1,000 MG/10 ML

Prescription Drug - Generic

$5

—

62756007164

PANTOPRAZOLE 40 MG SUSPENSION

Prescription Drug - Generic

$10

—

62756016191

DESMOPRESSIN 0.01% SPRAY

Prescription Drug - Generic

$35

—

62756029988

PHENYTOIN SOD EXT 200 MG CAP

Prescription Drug - Generic

$1

—

62756036988

METOPROLOL-HYDROCHLOROTHIAZIDE 100-50 MG TAB

Prescription Drug - Generic

$2

—

62756037088

METOPROLOL-HYDROCHLOROTHIAZIDE 50-25 MG TAB

Prescription Drug - Generic

$1

—

62756043088

LITHIUM CARBONATE 300 MG TAB

Prescription Drug - Generic

$0

—

62756043288

PHENYTOIN SOD EXT 300 MG CAP

Prescription Drug - Generic

$1

—

62756071860

OPCICON ONE-STEP 1.5 MG TABLET

Prescription Drug - Generic

$7

—

62756072060

MY CHOICE 1.5 MG TABLET

Prescription Drug - Generic

$6

—

62856024590

ARICEPT 5 MG TABLET

Prescription Drug - Brand

$16

—

62856024630

ARICEPT 10 MG TABLET

Prescription Drug - Brand

$16

—

62856024730

ARICEPT 23 MG TABLET

Prescription Drug - Brand

$14

—

62856040530

DAYVIGO 5 MG TABLET

Prescription Drug - Brand

$12

—

62856041030

DAYVIGO 10 MG TABLET

Prescription Drug - Brand

$12

—

62856052960

BELVIQ 10 MG TABLET

Prescription Drug - Brand

$5

—

62856053530

BELVIQ XR 20 MG TABLET

Prescription Drug - Brand

$10

—

62856058252

BANZEL 200 MG TABLET

Prescription Drug - Brand

$13

—

62856058352

BANZEL 400 MG TABLET

Prescription Drug - Brand

$25

—

62856058446

BANZEL 40 MG/ML SUSPENSION

Prescription Drug - Brand

$4

—

62856060210

TARGRETIN 75 MG SOFTGEL

Prescription Drug - Brand

$116

—

62856068010

ZONEGRAN 100 MG CAPSULE

Prescription Drug - Brand

$15

—

62856068110

ZONEGRAN 25 MG CAPSULE

Prescription Drug - Brand

$12

—

63001

Remove spine lamina 1/2 crvl

Surgery - Nervous

$1,194

—

63003

Remove spine lamina 1/2 thrc

Surgery - Nervous

$1,198

—

63005

Remove spine lamina 1/2 lmbr

Surgery - Nervous

$1,192

—

63010002770

VIRACEPT 625 MG TABLET

Prescription Drug - Brand

$10

—

63011

Remove spine lamina 1/2 scrl

Surgery - Nervous

$1,011

—

63012

Remove lamina/facets lumbar

Surgery - Nervous

$1,150

—

63015

Remove spine lamina >2 crvcl

Surgery - Nervous

$1,445

—

63016

Remove spine lamina >2 thrc

Surgery - Nervous

$1,463

—

63017

Remove spine lamina >2 lmbr

Surgery - Nervous

$1,245

—

63020

Lamot dcmprn nrv rt 1 cerv

Surgery - Nervous

$1,064

—

63020004901

VELCADE 3.5 MG VIAL

Prescription Drug - Brand

$1,508

—

63030

Lamot dcmprn nrv rt 1 lmbr

Surgery - Nervous

$898

—

63032

Lamot rpr anulr dfct 1 lmbr

Surgery - Nervous

$136

—

63032003100

OLUX 0.05% FOAM

Prescription Drug - Brand

$6

—

My Cost List