Medical Procedure Costs

00456152560

SAVELLA 25 MG TABLET

Prescription Drug - Brand

$8

—

00456155060

SAVELLA 50 MG TABLET

Prescription Drug - Brand

$8

—

00456200501

LEXAPRO 5 MG TABLET

Prescription Drug - Brand

$15

—

00456201001

LEXAPRO 10 MG TABLET

Prescription Drug - Brand

$15

—

00456202001

LEXAPRO 20 MG TABLET

Prescription Drug - Brand

$16

—

00456210108

LEXAPRO 5 MG/5 ML SOLUTION

Prescription Drug - Brand

$2

—

00456220228

FETZIMA 20-40 MG TITRATION PAK

Prescription Drug - Brand

$18

—

00456221230

FETZIMA ER 120 MG CAPSULE

Prescription Drug - Brand

$18

—

00456222030

FETZIMA ER 20 MG CAPSULE

Prescription Drug - Brand

$18

—

00456224030

FETZIMA ER 40 MG CAPSULE

Prescription Drug - Brand

$18

—

00456228030

FETZIMA ER 80 MG CAPSULE

Prescription Drug - Brand

$18

—

00456240211

SAPHRIS 2.5 MG TAB SUBLINGUAL BLACK CHERRY

Prescription Drug - Brand

$19

—

00456240260

SAPHRIS 2.5 MG TAB SUBLINGUAL

Prescription Drug - Brand

$21

—

00456240560

SAPHRIS 5 MG TAB SUBLINGUAL

Prescription Drug - Brand

$21

—

00456240563

SAPHRIS 5 MG TAB SUBLINGUAL BLACK CHERRY

Prescription Drug - Brand

$19

—

00456241060

SAPHRIS 10 MG TAB SUBLINGUAL

Prescription Drug - Brand

$21

—

00456241063

SAPHRIS 10 MG TAB SUBLINGUAL BLACK CHERRY

Prescription Drug - Brand

$19

—

00456261390

TIAZAC ER 180 MG CAPSULE

Prescription Drug - Brand

$2

—

00456320014

NAMENDA 5-10 MG TITRATION PK

Prescription Drug - Brand

$7

—

00456320212

NAMENDA 2 MG/ML SOLUTION

Prescription Drug - Brand

$2

—

00456320560

NAMENDA 5 MG TABLET

Prescription Drug - Brand

$7

—

00456321011

NAMENDA 10 MG TABLET

Prescription Drug - Brand

$7

—

00456333001

CAMPRAL DR 333 MG TABLET

Prescription Drug - Brand

$1

—

00456340029

NAMENDA XR TITRATION PACK

Prescription Drug - Brand

$15

—

00456340733

NAMENDA XR 7 MG CAPSULE

Prescription Drug - Brand

$15

—

00456341463

NAMENDA XR 14 MG CAPSULE

Prescription Drug - Brand

$15

—

00456342133

NAMENDA XR 21 MG CAPSULE

Prescription Drug - Brand

$15

—

00456342833

NAMENDA XR 28 MG CAPSULE

Prescription Drug - Brand

$15

—

00456401001

CELEXA 10 MG TABLET

Prescription Drug - Brand

$9

—

00456402001

CELEXA 20 MG TABLET

Prescription Drug - Brand

$9

—

00456404001

CELEXA 40 MG TABLET

Prescription Drug - Brand

$9

—

00456430001

MONUROL 3 GM SACHET

Prescription Drug - Brand

$87

—

0045U

mRNA gene analysis of 12 genes in breast ductal carcinoma in situ tumor tissue

Pathology/Laboratory

$3,873

—

00469052002

CRESEMBA 186 MG CAPSULE

Prescription Drug - Brand

$114

—

00469060773

PROGRAF 0.5 MG CAPSULE

Prescription Drug - Brand

$4

—

00469061773

PROGRAF 1 MG CAPSULE

Prescription Drug - Brand

$7

—

00469064773

ASTAGRAF XL 0.5 MG CAPSULE

Prescription Drug - Brand

$3

—

00469067773

ASTAGRAF XL 1 MG CAPSULE

Prescription Drug - Brand

$6

—

00469068773

ASTAGRAF XL 5 MG CAPSULE

Prescription Drug - Brand

$28

—

00469123050

PROGRAF 0.2 MG GRANULE PACKET

Prescription Drug - Brand

$5

—

00469260190

MYRBETRIQ ER 25 MG TABLET

Prescription Drug - Brand

$15

—

00469260290

MYRBETRIQ ER 50 MG TABLET

Prescription Drug - Brand

$15

—

00469266030

VEOZAH 45 MG TABLET

Prescription Drug - Brand

$19

—

00469502099

MYRBETRIQ ER 8 MG/ML SUSP

Prescription Drug - Brand

$2

—

00469520160

PROTOPIC 0.03% OINTMENT

Prescription Drug - Brand

$7

—

0046U

Gene analysis (fms-related tyrosine kinase 3) for internal tandem duplication

Pathology/Laboratory

$407

—

00472006675

MINOXIDIL 2% SOLUTION

Prescription Drug - Generic

$0

—

00472037145

BETAMETHASONE VALER 0.1% OINTM

Prescription Drug - Generic

$1

—

00472073542

ANTIFUNGAL 2% CREAM

Prescription Drug - Generic

$0

—

00472073556

ANTIFUNGAL 2% TOPICAL CREAM

Prescription Drug - Generic

$0

—

My Cost List