Medical Procedure Costs

64380071104

LAMIVUDINE 300 MG TABLET

Prescription Drug - Generic

$1

—

64380072106

TACROLIMUS 1 MG CAPSULE

Prescription Drug - Generic

$1

—

64380076621

PEG-3350 AND ELECTROLYTES SOLN

Prescription Drug - Generic

$0

—

64380076921

PEG 3350-ELECTROLYTE SOLUTION

Prescription Drug - Generic

$0

—

64380082706

KETOCONAZOLE 200 MG TABLET

Prescription Drug - Generic

$1

—

64380084206

PIROXICAM 10 MG CAPSULE

Prescription Drug - Generic

$0

—

64380084307

PIROXICAM 20 MG CAPSULE

Prescription Drug - Generic

$0

—

64380090206

FLUOXETINE HCL 10 MG TABLET

Prescription Drug - Generic

$0

—

64380090306

FLUOXETINE HCL 20 MG TABLET

Prescription Drug - Generic

$0

—

64380099704

IBUPROFEN 100 MG/5 ML SUSP

Prescription Drug - Generic

$0

—

64400

Njx aa&/strd trigeminal nrv

Surgery - Nervous

$47

—

64405

Njx aa&/strd gr ocpl nrv

Surgery - Nervous

$46

—

64408

Njx aa&/strd vagus nrv

Surgery - Nervous

$39

—

64415

Njx aa&/strd brch plxs img

Surgery - Nervous

$66

—

64416

Njx aa&/strd brch pl nfs img

Surgery - Nervous

$72

—

64417

Njx aa&/strd ax nerve img

Surgery - Nervous

$61

—

64418

Njx aa&/strd sprscap nrv

Surgery - Nervous

$48

—

64420

Njx aa&/strd ntrcost nrv 1

Surgery - Nervous

$52

—

64421

Njx aa&/strd ntrcost nrv ea

Surgery - Nervous

$22

—

64425

Njx aa&/strd ii ih nerves

Surgery - Nervous

$50

—

64430

Njx aa&/strd pudendal nerve

Surgery - Nervous

$49

—

64435

Njx aa&/strd paracrv nrv

Surgery - Nervous

$39

—

64445

Njx aa&/strd sciatic nrv img

Surgery - Nervous

$66

—

64446

Njx aa&/strd sc nrv nfs img

Surgery - Nervous

$71

—

64447

Njx aa&/strd femoral nrv img

Surgery - Nervous

$61

—

64448

Njx aa&/strd fem nrv nfs img

Surgery - Nervous

$68

—

64449

Njx aa&/strd lmbr plex nfs

Surgery - Nervous

$60

—

64450

Njx aa&/strd other pn/branch

Surgery - Nervous

$38

—

64451

Njx aa&/strd nrv nrvtg si jt

Surgery - Nervous

$72

—

64454

Njx aa&/strd gnclr nrv brnch

Surgery - Nervous

$73

—

64455

Njx aa&/strd pltr com dg nrv

Surgery - Nervous

$30

—

64455019201

ISORDIL 40 MG TABLET

Prescription Drug - Brand

$17

—

64455079650

CARDIZEM CD 180 MG CAPSULE

Prescription Drug - Brand

$29

—

64461

Pvb thoracic single inj site

Surgery - Nervous

$72

—

64462

Pvb thoracic 2nd+ inj site

Surgery - Nervous

$44

—

64463

Pvb thoracic cont infusion

Surgery - Nervous

$76

—

64466

Thrc fascial pln blk uni njx

Surgery - Nervous

$61

—

64467

Thrc fascial pln blk uni nfs

Surgery - Nervous

$71

—

64468

Thrc fascial pln blk bi njx

Surgery - Nervous

$68

—

64469

Thrc fascial pln blk bi nfs

Surgery - Nervous

$75

—

64473

Lwr xtr fscl pln blk uni njx

Surgery - Nervous

$55

—

64474

Lwr xtr fscl pln blk uni nfs

Surgery - Nervous

$68

—

64479

Njx aa&/strd tfrm epi c/t 1

Surgery - Nervous

$117

—

64480

Njx aa&/strd tfrm epi c/t ea

Surgery - Nervous

$53

—

64483

Njx aa&/strd tfrm epi l/s 1

Surgery - Nervous

$100

—

64484

Njx aa&/strd tfrm epi l/s ea

Surgery - Nervous

$44

—

64486

Tap block unil by injection

Surgery - Nervous

$48

—

64487

Tap block uni by infusion

Surgery - Nervous

$56

—

64488

Tap block bi injection

Surgery - Nervous

$57

—

64489

Tap block bi by infusion

Surgery - Nervous

$71

—

My Cost List