Medical Procedure Costs

00178089630

CITRANATAL MEDLEY SOFTGEL

Prescription Drug - Brand

$4

—

00178850060

TINDAMAX 500 MG TABLET

Prescription Drug - Brand

$13

—

0017M

mRNA gene expression profiling by fluorescent probe hybridization of 20 genes

Pathology/Laboratory

$2,510

—

0017U

JAK2 mutation test for detecting gene abnormality associated with blood and

Pathology/Laboratory

$92

—

00182109301

SENNA-GEN NF TABLET

Prescription Drug - Generic

$0

—

00182111301

SENNA S TABLET

Prescription Drug - Generic

$0

—

00185027260

OXANDROLONE 10 MG TABLET

Prescription Drug - Generic

$11

—

00185072405

CARISOPRODOL COMPOUND TAB

Prescription Drug - Generic

$1

—

00185075710

SULFADIAZINE 500 MG TABLET

Prescription Drug - Generic

$3

—

00185104710

QUINIDINE SULFATE 300 MG TAB

Prescription Drug - Generic

$0

—

00186000431

ATACAND 4 MG TABLET

Prescription Drug - Brand

$3

—

00186016254

ATACAND HCT 16-12.5 MG TAB

Prescription Drug - Brand

$4

—

00186032254

ATACAND HCT 32-12.5 MG TAB

Prescription Drug - Brand

$4

—

00186037028

SYMBICORT 160-4.5 MCG INHALER

Prescription Drug - Brand

$25

—

00186037228

SYMBICORT 80-4.5 MCG INHALER

Prescription Drug - Brand

$19

—

00186074282

PRILOSEC DR 20 MG CAPSULE

Prescription Drug - Brand

$7

—

00186074368

PRILOSEC DR 40 MG CAPSULE

Prescription Drug - Brand

$10

—

00186077660

BRILINTA 60 MG TABLET

Prescription Drug - Brand

$7

—

00186077760

BRILINTA 90 MG TABLET

Prescription Drug - Brand

$7

—

00186107008

RHINOCORT AQUA NASAL SPRAY

Prescription Drug - Brand

$17

—

00186198804

PULMICORT 0.25 MG/2 ML RESPUL

Prescription Drug - Brand

$4

—

00186198904

PULMICORT 0.5 MG/2 ML RESPULE

Prescription Drug - Brand

$5

—

00186199004

PULMICORT 1 MG/2 ML RESPULE

Prescription Drug - Brand

$10

—

00186401001

NEXIUM DR 10 MG PACKET

Prescription Drug - Brand

$9

—

00186402001

NEXIUM DR 20 MG PACKET

Prescription Drug - Brand

$9

—

00186402501

NEXIUM DR 2.5 MG PACKET

Prescription Drug - Brand

$9

—

00186404001

NEXIUM DR 40 MG PACKET

Prescription Drug - Brand

$9

—

00186405001

NEXIUM DR 5 MG PACKET

Prescription Drug - Brand

$9

—

00186502054

NEXIUM DR 20 MG CAPSULE

Prescription Drug - Brand

$9

—

00186504054

NEXIUM DR 40 MG CAPSULE

Prescription Drug - Brand

$9

—

00187000260

BRYHALI 0.01% LOTION

Prescription Drug - Brand

$5

—

00187000545

ALTRENO 0.05% LOTION

Prescription Drug - Brand

$2

—

00187000625

CABTREO 1.2%-0.15%-3.15% GEL

Prescription Drug - Brand

$18

—

00187006301

ATIVAN 0.5 MG TABLET

Prescription Drug - Brand

$35

—

00187006410

ATIVAN 1 MG TABLET

Prescription Drug - Brand

$47

—

00187006501

ATIVAN 2 MG TABLET

Prescription Drug - Brand

$76

—

00187010801

TUSSICAPS 10 MG-8 MG CAPSULE

Prescription Drug - Brand

$35

—

00187014190

VASOTEC 5 MG TABLET

Prescription Drug - Brand

$15

—

00187014290

VASOTEC 10 MG TABLET

Prescription Drug - Brand

$17

—

00187014390

VASOTEC 20 MG TABLET

Prescription Drug - Brand

$23

—

00187024503

MIGRANAL NASAL SPRAY

Prescription Drug - Brand

$460

—

00187039431

ELDOQUIN FORTE 4% CREAM

Prescription Drug - Generic

$3

—

00187045302

ZELAPAR 1.25 MG ODT TABLET

Prescription Drug - Brand

$67

—

00187065301

DUOBRII 0.01%-0.045% LOTION

Prescription Drug - Brand

$10

—

00187065820

DIASTAT ACUDIAL 5-7.5-10 MG KT

Prescription Drug - Brand

$336

—

00187065920

DIASTAT ACUDIAL 12.5-15-20 MG

Prescription Drug - Brand

$336

—

00187073090

WELLBUTRIN XL 150 MG TABLET

Prescription Drug - Brand

$70

—

00187073130

WELLBUTRIN XL 300 MG TABLET

Prescription Drug - Brand

$92

—

00187074633

INSTA-GLUCOSE GEL

Prescription Drug - Generic

$0

—

00187079542

CARDIZEM CD 120 MG CAPSULE

Prescription Drug - Brand

$27

—

My Cost List