Medical Procedure Costs

67450

Explore/biopsy eye socket

Surgery - Eye

$1,218

—

67457014630

B-COMPLEX 100 INJECTION

Prescription Drug - Generic

$6

—

67457034210

VANCOMYCIN HCL 10 GM VIAL

Prescription Drug - Generic

$36

—

67457042254

DEXAMETHASONE 20 MG/5 ML VIAL

Prescription Drug - Generic

$0

—

67457042612

HALOPERIDOL LAC 5 MG/ML VIAL

Prescription Drug - Generic

$1

—

67457047322

TOBRAMYCIN 80 MG/2 ML VIAL

Prescription Drug - Generic

$1

—

67457048040

METHOTREXATE 1 GRAM/40 ML VIAL

Prescription Drug - Generic

$1

—

67457048400

DEXAMETHASONE 120 MG/30 ML VL

Prescription Drug - Generic

$0

—

67457052433

IBANDRONATE 3 MG/3 ML SYRINGE

Prescription Drug - Generic

$54

—

67457061310

VANCOMYCIN HCL 5 GM VIAL

Prescription Drug - Generic

$28

—

67500

Inject/treat eye socket

Surgery - Eye

$55

—

67505

Inject/treat eye socket

Surgery - Eye

$58

—

67515

Inject/treat eye socket

Surgery - Eye

$38

—

67516

Sprchoroidal spc njx rx agt

Surgery - Eye

$80

—

67546011112

ALINIA 500 MG TABLET

Prescription Drug - Brand

$92

—

67550

Insert eye socket implant

Surgery - Eye

$956

—

67560

Revise eye socket implant

Surgery - Eye

$976

—

67570

Decompress optic nerve

Surgery - Eye

$1,108

—

67618010030

COLACE 50 MG CAPSULE

Prescription Drug - Brand

$0

—

67618010110

COLACE-T 100 MG CAPSULE

Prescription Drug - Brand

$0

—

67618010160

COLACE 100 MG CAPSULE

Prescription Drug - Brand

$0

—

67618010630

PERI-COLACE TABLET

Prescription Drug - Brand

$0

—

67618010760

SLOW-MAG 71.5 MG TABLET

Prescription Drug - Brand

$0

—

67618011060

COLACE 2-IN-1 TABLET

Prescription Drug - Brand

$0

—

67618011128

COLACE CLEAR 50 MG SOFTGEL

Prescription Drug - Brand

$0

—

67618012012

SENOKOT EXTRA STR 17.2 MG TAB

Prescription Drug - Brand

$0

—

67618014904

BETADINE 7.5% SKIN CLEANSER

Prescription Drug - Brand

$0

—

67618015017

BETADINE 10% SOLUTION

Prescription Drug - Brand

$0

—

67618015104

BETADINE SURGICAL SCRUB

Prescription Drug - Brand

$0

—

67618016003

BETADINE 5% SPRAY

Prescription Drug - Brand

$0

—

67618020008

BETASEPT 4% SURGICAL SCRUB

Prescription Drug - Generic

$0

—

67618030040

SENOKOT TO GO 8.6 MG TABLET

Prescription Drug - Brand

$0

—

67618030050

SENOKOT 8.6 MG TABLET

Prescription Drug - Brand

$0

—

67618031060

SENOKOT-S TABLET

Prescription Drug - Brand

$0

—

67700

Blepharotomy drg absc eyelid

Surgery - Eye

$103

—

67710

Severing tarsorrhaphy

Surgery - Eye

$87

—

67715

Canthotomy

Surgery - Eye

$102

—

67767020001

METHYLPHENIDATE ER-LA 20 MG CAPSULE

Prescription Drug - Generic

$4

—

67767020101

METHYLPHENIDATE ER-LA 30 MG CAPSULE

Prescription Drug - Generic

$4

—

67767020201

METHYLPHENIDATE ER-LA 40 MG CAPSULE

Prescription Drug - Generic

$5

—

67800

Remove eyelid lesion

Surgery - Eye

$87

—

67801

Remove eyelid lesions

Surgery - Eye

$110

—

67805

Remove eyelid lesions

Surgery - Eye

$139

—

67808

Remove eyelid lesion(s)

Surgery - Eye

$319

—

67810

Incal bx eyelid skn lid mrgn

Surgery - Eye

$55

—

67820

Revise eyelashes

Surgery - Eye

$19

—

67825

Revise eyelashes

Surgery - Eye

$108

—

67830

Revise eyelashes

Surgery - Eye

$119

—

67835

Revise eyelashes

Surgery - Eye

$379

—

67840

Remove eyelid lesion

Surgery - Eye

$134

—

My Cost List