Medical Procedure Costs

00781712254

ESTRADIOL TDS 0.0375 MG/DAY

Prescription Drug - Generic

$14

—

00781712258

ESTRADIOL 0.0375 MG PATCH(1/WK)

Prescription Drug - Generic

$12

—

00781712983

ESTRADIOL 0.025 MG PATCH

Prescription Drug - Generic

$7

—

00781713358

ESTRADIOL 0.05 MG PATCH (1/WK)

Prescription Drug - Generic

$11

—

00781713458

ESTRADIOL TDS 0.06 MG/DAY

Prescription Drug - Generic

$14

—

00781713658

ESTRADIOL 0.075 MG PATCH(1/WK)

Prescription Drug - Generic

$13

—

00781714483

ESTRADIOL 0.05 MG PATCH

Prescription Drug - Generic

$8

—

00781714629

IPRAT-ALBUT 0.5-3(2.5) MG/3 ML

Prescription Drug - Generic

$0

—

00781716783

ESTRADIOL 0.1 MG PATCH

Prescription Drug - Generic

$7

—

00781801731

FLUVASTATIN ER 80 MG TABLET

Prescription Drug - Generic

$3

—

0080U

Analysis of galectin-3-binding protein and scavenger receptor cysteine-rich

Pathology/Laboratory

$3,520

—

00813001206

FERRETTS 325 MG TABLET

Prescription Drug - Generic

$0

—

0082U

Definitive drug testing for 90 or more drugs in urine

Pathology/Laboratory

$247

—

00832022500

MORPHINE SULFATE ER 10 MG CAP

Prescription Drug - Generic

$3

—

00832022600

MORPHINE SULFATE ER 20 MG CAP

Prescription Drug - Generic

$3

—

00832022700

MORPHINE SULFATE ER 30 MG CAP

Prescription Drug - Generic

$3

—

00832022800

MORPHINE SULFATE ER 50 MG CAP

Prescription Drug - Generic

$3

—

00832022900

MORPHINE SULFATE ER 60 MG CAP

Prescription Drug - Generic

$5

—

00832023000

MORPHINE SULFATE ER 80 MG CAP

Prescription Drug - Generic

$5

—

00832023300

MORPHINE SULFATE ER 100 MG CAP

Prescription Drug - Generic

$7

—

00832046560

NYAMYC 100,000 UNIT/GM POWDER

Prescription Drug - Generic

$0

—

00832112005

TESTOSTERONE 50 MG/5 GRAM GEL

Prescription Drug - Generic

$1

—

00832112035

TESTOSTERONE 50 MG/5 GRAM PKT

Prescription Drug - Generic

$1

—

00832121189

JANTOVEN 1 MG TABLET

Prescription Drug - Generic

$0

—

00832121289

JANTOVEN 2 MG TABLET

Prescription Drug - Generic

$0

—

00832121389

JANTOVEN 2.5 MG TABLET

Prescription Drug - Generic

$0

—

00832121489

JANTOVEN 3 MG TABLET

Prescription Drug - Generic

$0

—

00832121589

JANTOVEN 4 MG TABLET

Prescription Drug - Generic

$0

—

00832121689

JANTOVEN 5 MG TABLET

Prescription Drug - Generic

$0

—

00832121701

JANTOVEN 6 MG TABLET

Prescription Drug - Generic

$0

—

00832121889

JANTOVEN 7.5 MG TABLET

Prescription Drug - Generic

$0

—

00832121989

JANTOVEN 10 MG TABLET

Prescription Drug - Generic

$0

—

0083U

Evaluation of response to chemotherapy drugs using motility contrast tomography

Pathology/Laboratory

$167

—

0084U

DNA red blood cell antigen typing

Pathology/Laboratory

$720

—

0086U

FISH identification of organisms in blood culture

Pathology/Laboratory

$200

—

0087U

mRNA gene expression profiling of genes in heart transplant biopsy tissue to

Pathology/Laboratory

$3,159

—

00884029301

FUNGOID 2% TINCTURE

Prescription Drug - Brand

$1

—

00884044904

UREACIN-20 CREAM

Prescription Drug - Brand

$0

—

0088U

mRNA gene expression profiling of genes in kidney transplant tissue to evaluate

Pathology/Laboratory

$3,159

—

0089U

Gene expression profiling of melanoma in superficial sample collected by

Pathology/Laboratory

$760

—

00904000414

MI ACID SUSPENSION

Prescription Drug - Generic

$0

—

00904001280

ALLERGY 4 MG TABLET

Prescription Drug - Generic

$0

—

00904004920

FORMULA EM SOLUTION

Prescription Drug - Generic

$0

—

00904005300

ROBAFEN-DM SYRUP

Prescription Drug - Generic

$0

—

00904006116

ROBAFEN 100 MG/5 ML SYRUP

Prescription Drug - Generic

$0

—

00904064360

NITROGLYCERIN ER 2.5 MG CAP

Prescription Drug - Generic

$0

—

00904064452

NITROGLYCERIN ER 6.5 MG CAP

Prescription Drug - Generic

$0

—

00904072236

ANTIFUNGAL 1% CREAM

Prescription Drug - Generic

$0

—

00904100716

POTASSIUM CL 10% (20 MEQ/15 ML

Prescription Drug - Generic

$0

—

00904110231

POVIDONE-IODINE 10% OINTMENT

Prescription Drug - Generic

$0

—

My Cost List