Medical Procedure Costs

10631010030

EXELDERM 1% SOLUTION

Prescription Drug - Brand

$10

—

10631011669

ABSORICA 20 MG CAPSULE

Prescription Drug - Brand

$35

—

10631011769

ABSORICA 30 MG CAPSULE

Prescription Drug - Brand

$38

—

10631011869

ABSORICA 40 MG CAPSULE

Prescription Drug - Brand

$38

—

10631011901

ULTRAVATE X OINTMENT COMBO PAC

Prescription Drug - Brand

$3

—

10631023802

RIOMET 500 MG/5 ML SOLUTION

Prescription Drug - Brand

$1

—

10631028605

LAC-HYDRIN FIVE 5% LOTION

Prescription Drug - Brand

$0

—

10631040701

PROCTOSOL-HC 2.5% CREAM

Prescription Drug - Brand

$1

—

10702000109

LOMAIRA 8 MG TABLET

Prescription Drug - Generic

$1

—

10702001724

CHLORPHENIRAMINE ER 12 MG TAB

Prescription Drug - Generic

$0

—

10702003645

KALEXATE POWDER

Prescription Drug - Generic

$0

—

11000

Dbrdmt ecz/infected skin<10%

Surgery - Integumentary

$24

—

11001

Dbrdmt ecz/infct skn ea addl

Surgery - Integumentary

$13

—

11004

Dbrdmt skin xtrnl gent&per

Surgery - Integumentary

$505

—

11005

Dbrdmt skin abdominal wall

Surgery - Integumentary

$693

—

11006

Dbrdmt skin xtrnl gent per

Surgery - Integumentary

$624

—

11008

Rmv prstc mtrl/mesh abd wall

Surgery - Integumentary

$244

—

11010

Debride skin at fx site

Surgery - Integumentary

$250

—

11011

Debride skin musc at fx site

Surgery - Integumentary

$265

—

11012

Deb skin bone at fx site

Surgery - Integumentary

$362

—

11042

Dbrdmt subq tis 1st 20sqcm/<

Surgery - Integumentary

$56

—

11043

Dbrdmt musc&/fsca 1st 20/<

Surgery - Integumentary

$138

—

11044

Dbrdmt bone 1st 20 sq cm/<

Surgery - Integumentary

$201

—

11045

Dbrdmt subq tiss each addl

Surgery - Integumentary

$22

—

11046

Dbrdmt musc&/fsca ea addl

Surgery - Integumentary

$48

—

11047

Dbrdmt bone each addl

Surgery - Integumentary

$85

—

11055

Paring/cutg b9 hyprker les 1

Surgery - Integumentary

$14

—

11056

Parng/cutg b9 hyprkr les 2-4

Surgery - Integumentary

$20

—

11057

Parng/cutg b9 hyprkr les >4

Surgery - Integumentary

$25

—

11102

Tangntl bx skin single les

Surgery - Integumentary

$30

—

11103

Tangntl bx skin ea sep/addl

Surgery - Integumentary

$18

—

11104

Punch bx skin single lesion

Surgery - Integumentary

$38

—

11105

Punch bx skin ea sep/addl

Surgery - Integumentary

$21

—

11106

Incal bx skn single les

Surgery - Integumentary

$46

—

11107

Incal bx skn ea sep/addl

Surgery - Integumentary

$25

—

11200

Rmvl skin tags up to&inc 15

Surgery - Integumentary

$69

—

11201

Rmvl skin tags ea addl 10

Surgery - Integumentary

$13

—

11300

Shave skin lesion 0.5 cm/<

Surgery - Integumentary

$28

—

11301

Shave skin lesion 0.6-1.0 cm

Surgery - Integumentary

$42

—

11302

Shave skin lesion 1.1-2.0 cm

Surgery - Integumentary

$48

—

11303

Shave skin lesion >2.0 cm

Surgery - Integumentary

$58

—

11305

Shave skin lesion 0.5 cm/<

Surgery - Integumentary

$33

—

11306

Shave skin lesion 0.6-1.0 cm

Surgery - Integumentary

$41

—

11307

Shave skin lesion 1.1-2.0 cm

Surgery - Integumentary

$51

—

11308

Shave skin lesion >2.0 cm

Surgery - Integumentary

$60

—

11310

Shave skin lesion 0.5 cm/<

Surgery - Integumentary

$36

—

11311

Shave skin lesion 0.6-1.0 cm

Surgery - Integumentary

$51

—

11312

Shave skin lesion 1.1-2.0 cm

Surgery - Integumentary

$60

—

11313

Shave skin lesion >2.0 cm

Surgery - Integumentary

$77

—

11383011850

SLEEPING 50 MG CAPSULE

Prescription Drug - Generic

$0

—

My Cost List