Medical Procedure Costs

00713087530

TRIBENZOR 40-5-12.5 MG TABLET

Prescription Drug - Brand

$16

—

00713087830

TRIBENZOR 40-10-25 MG TABLET

Prescription Drug - Brand

$18

—

00713087981

WELCHOL 625 MG TABLET

Prescription Drug - Brand

$5

—

00713088230

EFFIENT 10 MG TABLET

Prescription Drug - Brand

$19

—

00713088301

EVOXAC 30 MG CAPSULE

Prescription Drug - Brand

$8

—

00713088530

CLOMID 50 MG TABLET

Prescription Drug - Brand

$11

—

00713542101

AMBIEN 10 MG TABLET

Prescription Drug - Brand

$23

—

00713552101

AMBIEN CR 12.5 MG TABLET

Prescription Drug - Brand

$23

—

0071U

Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) full

Pathology/Laboratory

$600

—

0072U

Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) targeted

Pathology/Laboratory

$451

—

0073U

Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) targeted

Pathology/Laboratory

$451

—

0074U

Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) targeted

Pathology/Laboratory

$451

—

0075U

Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) targeted

Pathology/Laboratory

$451

—

0076U

Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) targeted

Pathology/Laboratory

$451

—

00777310402

PROZAC 10 MG PULVULE

Prescription Drug - Brand

$14

—

00777310530

PROZAC 20 MG PULVULE

Prescription Drug - Brand

$14

—

00777310730

PROZAC 40 MG PULVULE

Prescription Drug - Brand

$24

—

0077U

Detection of Immunoglobulin paraprotein (M-protein) in blood or urine

Pathology/Laboratory

$43

—

00781135801

CLEMASTINE FUM 1.34 MG TABLET

Prescription Drug - Generic

$0

—

00781155601

ISOSORBIDE DN 10 MG TABLET

Prescription Drug - Generic

$1

—

00781164366

AMOX TR-K CLV 400-57 TAB CHEW

Prescription Drug - Generic

$3

—

00781164601

NAPROXEN EC 375 MG TABLET

Prescription Drug - Generic

$0

—

00781165301

NAPROXEN EC 500 MG TABLET

Prescription Drug - Generic

$0

—

00781194382

AMOX-CLAV ER 1,000-62.5 MG TAB

Prescription Drug - Generic

$6

—

00781208102

CALCIUM ACETATE 667 MG GELCAP

Prescription Drug - Generic

$0

—

00781245292

DILTIAZEM HCL ER 120 MG CAP

Prescription Drug - Generic

$0

—

00781245492

DILTIAZEM HCL ER 240 MG CAP

Prescription Drug - Generic

$1

—

00781245692

DILTIAZEM HCL ER 360 MG CAP

Prescription Drug - Generic

$1

—

00781245792

DILTIAZEM HCL ER 420 MG CAP

Prescription Drug - Generic

$1

—

00781271501

TRIAMTERENE-HYDROCHLOROTHIAZIDE 50-25 MG CAP

Prescription Drug - Generic

$2

—

00781300107

OMNITROPE 5 MG/1.5 ML CRTG

Prescription Drug - Brand

$430

—

00781300407

OMNITROPE 10 MG/1.5 ML CRTG

Prescription Drug - Brand

$855

—

00781317007

SUMATRIPTAN 4 MG/0.5 ML CART

Prescription Drug - Generic

$165

—

00781317307

SUMATRIPTAN 6 MG/0.5 ML REFILL

Prescription Drug - Generic

$104

—

00781323434

GLATOPA 20 MG/ML SYRINGE

Prescription Drug - Generic

$44

—

00781325089

GLATOPA 40 MG/ML SYRINGE

Prescription Drug - Generic

$104

—

00781344220

SYMJEPI 0.3 MG/0.3 ML SYRINGE

Prescription Drug - Brand

$120

—

00781400436

OMNITROPE 5.8 MG VIAL

Prescription Drug - Brand

$326

—

00781405815

ESTARYLLA 0.25 MG-0.035 MG TABLET

Prescription Drug - Generic

$0

—

00781410352

DROSP-EE-LEVOMEF 3-0.03-0.451

Prescription Drug - Generic

$3

—

00781528364

CETIRIZINE HCL 5 MG CHEW TAB

Prescription Drug - Generic

$2

—

00781528464

CETIRIZINE HCL 10 MG CHEW TAB

Prescription Drug - Generic

$2

—

00781563431

PIOGLITAZ-GLIMEPIR 30-2 MG TAB

Prescription Drug - Generic

$9

—

00781563531

PIOGLITAZ-GLIMEPIR 30-4 MG TAB

Prescription Drug - Generic

$10

—

00781566901

CARBIDOPA-LEVODOPA-ENTA 200 MG

Prescription Drug - Generic

$1

—

00781575401

METHYLPHENIDATE SR 20 MG TAB

Prescription Drug - Generic

$4

—

00781602246

CLARITHROMYCIN 125 MG/5 ML SUS

Prescription Drug - Generic

$1

—

00781602352

CLARITHROMYCIN 250 MG/5 ML SUS

Prescription Drug - Generic

$1

—

00781710458

ESTRADIOL TDS 0.1 MG/DAY

Prescription Drug - Generic

$14

—

00781711958

ESTRADIOL TDS 0.025 MG/DAY

Prescription Drug - Generic

$13

—

My Cost List