Medical Procedure Costs

70700018501

CHLORDIAZEPOXIDE-CLIDINIUM CAP

Prescription Drug - Generic

$0

—

70700020693

JAIMIESS 0.15-0.03-0.01 MG TAB

Prescription Drug - Generic

$0

—

70700020793

LOJAIMIESS 0.1-0.02-0.01 TAB

Prescription Drug - Generic

$0

—

70700026899

FOSFOMYCIN 3 GM SACHET

Prescription Drug - Generic

$35

—

70700027322

ESTRADIOL VALERATE 50 MG/5 ML

Prescription Drug - Generic

$19

—

70700027422

ESTRADIOL VALERATE 100 MG/5 ML

Prescription Drug - Generic

$22

—

70700027522

ESTRADIOL VALERATE 200 MG/5 ML

Prescription Drug - Generic

$34

—

70700028622

PROGESTERONE 500 MG/10 ML VIAL

Prescription Drug - Generic

$2

—

70700028822

TESTOSTERONE CYP 1,000 MG/10 ML

Prescription Drug - Generic

$6

—

70700029022

TESTOSTERONE CYP 2,000 MG/10 ML

Prescription Drug - Generic

$3

—

70700030385

ABIGALE LO 0.5-0.1 MG TABLET

Prescription Drug - Generic

$1

—

70700030585

VALTYA 1 MG-50 MCG TABLET

Prescription Drug - Generic

$1

—

70700030685

GALBRIELA 0.8-0.025 MG CHEW TB

Prescription Drug - Generic

$2

—

70700030785

FEIRZA 1 MG-20 MCG TABLET

Prescription Drug - Generic

$0

—

70700030885

XELRIA FE 0.4-0.035 MG CHEW TB

Prescription Drug - Generic

$0

—

70700030985

FEIRZA 1.5 MG-30 MCG TABLET

Prescription Drug - Generic

$0

—

70700031085

XARAH FE 1 MG/20-30-35 MCG TAB

Prescription Drug - Generic

$1

—

70700031287

ROSYRAH TABLET

Prescription Drug - Generic

$1

—

70700031379

LUIZZA 1 MG-20 MCG TABLET

Prescription Drug - Generic

$0

—

70700031479

LUIZZA 1.5 MG-30 MCG TABLET

Prescription Drug - Generic

$0

—

70700031527

MEDROXYPROGESTERONE 150 MG/ML

Prescription Drug - Generic

$20

—

70700031685

ORQUIDEA 0.35 MG TABLET

Prescription Drug - Generic

$0

—

70700031785

MELEYA 0.35 MG TABLET

Prescription Drug - Generic

$0

—

70700032650

GALLIFREY 5 MG TABLET

Prescription Drug - Generic

$0

—

70700033085

ABIGALE 1 MG-0.5 MG TABLET

Prescription Drug - Generic

$1

—

70710102208

ISOTRETINOIN 10 MG CAPSULE

Prescription Drug - Generic

$2

—

70710102308

ISOTRETINOIN 20 MG CAPSULE

Prescription Drug - Generic

$2

—

70710102408

ISOTRETINOIN 30 MG CAPSULE

Prescription Drug - Generic

$2

—

70710102508

ISOTRETINOIN 40 MG CAPSULE

Prescription Drug - Generic

$2

—

70710106101

ALBUTEROL SULFATE 2 MG TAB

Prescription Drug - Generic

$0

—

70710106201

ALBUTEROL SULFATE 4 MG TAB

Prescription Drug - Generic

$0

—

70710106903

VARDENAFIL HCL 5 MG TABLET

Prescription Drug - Generic

$7

—

70710107003

VARDENAFIL HCL 10 MG TABLET

Prescription Drug - Generic

$2

—

70710107103

VARDENAFIL HCL 20 MG TABLET

Prescription Drug - Generic

$3

—

70710111403

TERIFLUNOMIDE 7 MG TABLET

Prescription Drug - Generic

$1

—

70710111503

TERIFLUNOMIDE 14 MG TABLET

Prescription Drug - Generic

$1

—

70710112101

DOXYCYCLINE MONO 50 MG TABLET

Prescription Drug - Generic

$0

—

70710112201

DOXYCYCLINE MONO 75 MG TABLET

Prescription Drug - Generic

$0

—

70710112307

DOXYCYCLINE MONO 100 MG TABLET

Prescription Drug - Generic

$0

—

70710112403

DOXYCYCLINE MONO 150 MG TABLET

Prescription Drug - Generic

$1

—

70710112701

URSODIOL 250 MG TABLET

Prescription Drug - Generic

$0

—

70710112801

URSODIOL 500 MG TABLET

Prescription Drug - Generic

$1

—

70710112901

CHLORPROMAZINE 10 MG TABLET

Prescription Drug - Generic

$0

—

70710113703

FLUCONAZOLE 50 MG TABLET

Prescription Drug - Generic

$0

—

70710113803

FLUCONAZOLE 100 MG TABLET

Prescription Drug - Generic

$0

—

70710113908

FLUCONAZOLE 150 MG TABLET

Prescription Drug - Generic

$0

—

70710114003

FLUCONAZOLE 200 MG TABLET

Prescription Drug - Generic

$0

—

70710115909

MIRABEGRON ER 25 MG TABLET

Prescription Drug - Generic

$10

—

70710116009

MIRABEGRON ER 50 MG TABLET

Prescription Drug - Generic

$10

—

70710116101

MECLIZINE 12.5 MG TABLET

Prescription Drug - Generic

$0

—

My Cost List