Medical Procedure Costs

00573245043

NEXIUM 24HR 22.3 MG CAPSULE

Prescription Drug - Brand

$1

—

00573262165

ALAVERT 10 MG ODT

Prescription Drug - Brand

$0

—

00573266024

ALAVERT D-12 ALLERGY-SINUS TAB

Prescription Drug - Brand

$1

—

00573283010

PREPARATION H HC 1% CREAM

Prescription Drug - Brand

$0

—

00573284020

PREPARATION H COOLING GEL

Prescription Drug - Brand

$0

—

00573286810

PREPARATION H CREAM

Prescription Drug - Brand

$0

—

00573287120

PREPARATION H OINTMENT

Prescription Drug - Brand

$0

—

00573288320

PREPARATION H SUPPOSITORY

Prescription Drug - Brand

$0

—

00573295220

PRIMATENE ASTHMA TABLET

Prescription Drug - Brand

$0

—

00574006945

GLUTOSE 45 GEL

Prescription Drug - Generic

$0

—

00574007030

GLUTOSE 15 GEL

Prescription Drug - Generic

$0

—

00574010770

CLOTRIMAZOLE 10 MG TROCHE

Prescription Drug - Generic

$0

—

00574015004

MIDAZOLAM HCL 2 MG/ML SYRUP

Prescription Drug - Generic

$1

—

00574040415

NYSTATIN 150,000,000 UNITS PWD

Prescription Drug - Generic

$77

—

00574061105

PODOFILOX 0.5% TOPICAL SOLN

Prescription Drug - Generic

$16

—

00574061816

MINERAL OIL LAXATIVE

Prescription Drug - Generic

$0

—

00574062105

PODOFILOX 0.5% GEL

Prescription Drug - Generic

$132

—

00574085010

DIHYDROERGOTAMINE 1 MG/ML AM

Prescription Drug - Generic

$103

—

00574087005

ESTRADIOL VALERATE 20 MG/ML VL

Prescription Drug - Generic

$20

—

00574087205

ESTRADIOL VALERATE 40 MG/ML VL

Prescription Drug - Generic

$31

—

00574200316

SOD POLYSTYREN SULF 15 G/60 ML

Prescription Drug - Generic

$0

—

00574200416

KIONEX POWDER

Prescription Drug - Generic

$0

—

00574200830

NYSTOP 100,000 UNIT/GM POWDER

Prescription Drug - Generic

$0

—

00574202007

COLOCORT 100 MG/60 ML ENEMA

Prescription Drug - Generic

$0

—

00574206727

EVAMIST 1.53 MG/SPRAY

Prescription Drug - Brand

$18

—

00574241065

METHYLPHENIDATE 10 MG/9 HR PATCH

Prescription Drug - Generic

$9

—

00574241565

METHYLPHENIDATE 15 MG/9 HR PATCH

Prescription Drug - Generic

$8

—

00574242065

METHYLPHENIDATE 20 MG/9 HR PATCH

Prescription Drug - Generic

$9

—

00574243065

METHYLPHENIDATE 30 MG/9 HR PATCH

Prescription Drug - Generic

$9

—

00574402135

POLYCIN EYE OINTMENT

Prescription Drug - Generic

$3

—

00574402235

BACITRACIN 500 UNIT/GM OPHTHALMIC OINTMENT

Prescription Drug - Generic

$30

—

00574410235

GENTAMICIN 0.3% EYE OINTMENT

Prescription Drug - Generic

$4

—

00574414435

NEO-POLYCIN HC EYE OINTMENT

Prescription Drug - Generic

$6

—

00574425035

NEO-POLYCIN EYE OINTMENT

Prescription Drug - Generic

$5

—

00574704012

BELLADONNA-OPIUM 16.2-60 SUPP

Prescription Drug - Generic

$25

—

00574704512

BELLADONNA-OPIUM 16.2-30 SUPP

Prescription Drug - Generic

$21

—

00574722406

HYDROMORPHONE 3 MG SUPPOS

Prescription Drug - Generic

$10

—

00574722612

COMPRO 25 MG SUPPOSITORY

Prescription Drug - Brand

$6

—

00575620030

PROGLYCEM 50 MG/ML ORAL SUSP

Prescription Drug - Brand

$17

—

0058U

Measurement of antibodies to Merkel cell polyoma virus oncoprotein in serum

Pathology/Laboratory

$323

—

00591039601

PENTAZOCINE-ACETAMINOPHEN 25-650 TABLET

Prescription Drug - Generic

$1

—

00591039760

DICLOFENAC-MISOPROST 50-0.2 TB

Prescription Drug - Generic

$2

—

00591041401

ESTROPIPATE 0.625(0.75 MG) TAB

Prescription Drug - Generic

$0

—

00591041501

ESTROPIPATE 1.25(1.5 MG) TAB

Prescription Drug - Generic

$1

—

00591041601

ESTROPIPATE 2.5(3 MG) TAB

Prescription Drug - Generic

$1

—

00591236360

TESTOSTERONE 10 MG GEL PUMP

Prescription Drug - Generic

$5

—

00591246618

FLUTAMIDE 125 MG CAPSULE

Prescription Drug - Generic

$1

—

00591251030

BUDESONIDE ER 9 MG TABLET

Prescription Drug - Generic

$18

—

00591264101

BUTALBITAL-ACETAMINOPHEN-CAFFEINE-CODEINE 50-300-40-30 MG CP

Prescription Drug - Generic

$5

—

00591271960

METFORMIN HCL ER 500 MG OSM-TB

Prescription Drug - Generic

$3

—

My Cost List