Medical Procedure Costs

00603085194

Q-TAPP ELIXIR

Prescription Drug - Generic

$0

—

00603085294

Q-TAPP DM ELIXIR

Prescription Drug - Generic

$0

—

00603085581

Q-TUSSIN DM SYRUP

Prescription Drug - Generic

$0

—

00603085594

Q-TUSSIN-DM SYRUP

Prescription Drug - Generic

$0

—

00603085794

Q-TUSSIN 100 MG/5 ML SOLUTION

Prescription Drug - Generic

$0

—

00603099189

NATURAL VEGETABLE FIBER POWDER

Prescription Drug - Generic

$0

—

00603099263

VEGETABLE LAXATIVE POWDER

Prescription Drug - Generic

$0

—

00603107558

CHERATUSSIN AC SYRUP

Prescription Drug - Generic

$0

—

00603107858

CHERATUSSIN DAC SYRUP

Prescription Drug - Generic

$0

—

00603129558

HYDROCODONE-ACETAMINOPHEN 7.5 MG-500 MG/15 ML SOLUTION

Prescription Drug - Generic

$0

—

00603132858

IOPHEN NR LIQUID

Prescription Drug - Generic

$0

—

00603132958

IOPHEN-C NR LIQUID

Prescription Drug - Generic

$0

—

00603133058

IOPHEN DM-NR LIQUID

Prescription Drug - Generic

$0

—

00603158758

PROMETHAZINE VC SYRUP

Prescription Drug - Generic

$0

—

00603158858

PROMETHAZINE VC-CODEINE SYRUP

Prescription Drug - Generic

$0

—

00603178547

TRI-VIT-FLUOR 0.25 MG/ML DROP

Prescription Drug - Generic

$0

—

00603178747

TRI-VIT-FLUOR-IRON 0.25 MG/ML

Prescription Drug - Generic

$1

—

00603254021

ACETAMINOPHEN-BUTALBITAL 325-50 TAB

Prescription Drug - Generic

$1

—

00603333021

DIMENHYDRINATE 50 MG TABLET

Prescription Drug - Generic

$0

—

00603359049

GILDAGIA 0.4 MG-0.035 MG TAB

Prescription Drug - Generic

$0

—

00603388021

HYDROCODONE-ACETAMINOPHEN 2.5-500 TAB

Prescription Drug - Generic

$0

—

00603388712

HYDROCODONE-ACETAMINOPHEN 10-325 TABLET

Prescription Drug - Generic

$0

—

00603389032

HYDROCODONE-ACETAMINOPHEN 5-325 TABLET

Prescription Drug - Generic

$0

—

00603417016

K EFFERVESCENT 25 MEQ TABLET

Prescription Drug - Generic

$0

—

00603438228

MULT-VIT-FLUOR 0.5 MG TAB CHW

Prescription Drug - Generic

$0

—

00603441621

MEPERITAB 100 MG TABLET

Prescription Drug - Generic

$2

—

00603497821

OXYCODON-ACETAMINOPHEN 2.5-325

Prescription Drug - Generic

$1

—

00603499721

OXYCODONE-ACETAMINOPHEN 5-500 MG CAP

Prescription Drug - Generic

$0

—

00603580128

SULFAZINE 500 MG TABLET

Prescription Drug - Generic

$0

—

00603580321

SULFAZINE EC 500 MG TAB

Prescription Drug - Generic

$0

—

00603751249

KIMIDESS 28 DAY TABLET

Prescription Drug - Generic

$0

—

00603752149

CYCLAFEM 1-35-28 TABLET

Prescription Drug - Generic

$0

—

00603752549

CYCLAFEM 7-7-7-28 TABLET

Prescription Drug - Generic

$0

—

00603760615

GILDESS 1.5 MG-30 MCG TABLET

Prescription Drug - Generic

$1

—

00603760748

GILDESS 1 MG-20 MCG TABLET

Prescription Drug - Generic

$1

—

00603760817

GILDESS FE 1.5-30 TABLET

Prescription Drug - Generic

$0

—

00603760917

GILDESS FE 1-20 TABLET

Prescription Drug - Generic

$0

—

00603761017

GILDESS 24 FE 1-0.02 MG TABLET

Prescription Drug - Generic

$1

—

00603762549

MYZILRA-28 TABLET

Prescription Drug - Generic

$0

—

0060U

Gene analysis for identical twins in maternal blood

Pathology/Laboratory

$759

—

0061U

Spatial frequency domain imaging of skin

Pathology/Laboratory

$25

—

0062U

IgG and IgM analysis of 80 biomarkers of systemic lupus erythematosus in serum

Pathology/Laboratory

$381

—

0063U

Testing for amines associated with autism spectrum disorder in plasma

Pathology/Laboratory

$750

—

00641602410

FENTANYL 100 MCG/2 ML AMPUL

Prescription Drug - Generic

$1

—

00641602605

FENTANYL 1,000 MCG/20 ML AMPUL

Prescription Drug - Generic

$1

—

00641605001

LORAZEPAM 20 MG/10 ML VIAL

Prescription Drug - Generic

$2

—

00641607025

MORPHINE 10 MG/ML VIAL

Prescription Drug - Generic

$1

—

00641612525

MORPHINE SULFATE 4 MG/ML VIAL

Prescription Drug - Generic

$2

—

00641612725

MORPHINE SULFATE 10 MG/ML VIAL

Prescription Drug - Generic

$2

—

00641620825

PROMETHAZINE 25 MG/ML VIAL

Prescription Drug - Generic

$2

—

My Cost List