Medical Procedure Costs

15852

Dressing change not for burn

Surgery - Integumentary

$39

—

15853

Removal sutr/stapl xreq anes

Surgery - Integumentary

$13

—

15854

Removal sutr&stapl xreq anes

Surgery - Integumentary

$18

—

15860

Iv njx tst vasc flo flap/grf

Surgery - Integumentary

$93

—

15920

Exc coccygl pr ulc prim sutr

Surgery - Integumentary

$628

—

15922

Exc coccygl pr ulc flap clsr

Surgery - Integumentary

$731

—

15931

Exc sacral pr ulc prim sutr

Surgery - Integumentary

$673

—

15933

Exc sac pr ulc prim str ostc

Surgery - Integumentary

$823

—

15934

Exc sacral pr ulc skn flap

Surgery - Integumentary

$888

—

15935

Exc sac pr ulc skn flp ostc

Surgery - Integumentary

$1,045

—

15936

Exc sac pr ulc prep mus flap

Surgery - Integumentary

$838

—

15937

Exc sac pr ulc prep mus ostc

Surgery - Integumentary

$920

—

15940

Exc ischial pr ulc prim sutr

Surgery - Integumentary

$664

—

15941

Exc isch pr ulc prm sut ostc

Surgery - Integumentary

$866

—

15944

Exc isch pr ulc skn flp clsr

Surgery - Integumentary

$851

—

15945

Exc isch pr ulc skn flp ostc

Surgery - Integumentary

$927

—

15946

Exc isch pr ulc prep mus flp

Surgery - Integumentary

$1,461

—

15950

Exc trchntr pr ulc prim sutr

Surgery - Integumentary

$589

—

15951

Exc trchntr pr ulc ostc

Surgery - Integumentary

$824

—

15952

Exc trchntr pr ulc flp clsr

Surgery - Integumentary

$833

—

15953

Exc trchntr pr ulc flp ostc

Surgery - Integumentary

$918

—

15956

Exc trchntr pr ulc prep flap

Surgery - Integumentary

$1,093

—

15958

Exc trchntr pr ulc prep ostc

Surgery - Integumentary

$1,084

—

16000

Initial treatment of burn(s)

Surgery - Integumentary

$42

—

16020

Dress/debrid p-thick burn s

Surgery - Integumentary

$54

—

16025

Dress/debrid p-thick burn m

Surgery - Integumentary

$102

—

16030

Dress/debrid p-thick burn l

Surgery - Integumentary

$123

—

16035

Escharotomy 1st incision

Surgery - Integumentary

$179

—

16036

Escharotomy ea addl incision

Surgery - Integumentary

$73

—

16103034711

PHARBEDRYL 50 MG CAPSULE

Prescription Drug - Generic

$0

—

16103034811

PHARBEDRYL 25 MG CAPSULE

Prescription Drug - Generic

$0

—

16103035011

PHARBETOL 500 MG CAPLET

Prescription Drug - Generic

$0

—

16103035307

PHARBETOL 325 MG TABLET

Prescription Drug - Generic

$0

—

16103036611

ASPIRIN 81 MG TABLET CHEW

Prescription Drug - Generic

$0

—

16103036911

CALCIUM + VITAMIN D TABLET

Prescription Drug - Generic

$0

—

16103037611

PHARBETOL 500 MG TABLET

Prescription Drug - Generic

$0

—

16477012030

DALLERGY DROPS

Prescription Drug - Brand

$1

—

16571007112

CEFACLOR 250 MG/5 ML SUSP

Prescription Drug - Generic

$2

—

16571011124

CHLORHEXIDINE 4% LIQUID

Prescription Drug - Generic

$0

—

16571013412

CETIRIZINE HCL 1 MG/ML SYRUP

Prescription Drug - Generic

$0

—

16571020150

DICLOFENAC SOD EC 75 MG TAB

Prescription Drug - Generic

$0

—

16571020310

DICLOFENAC SOD EC 25 MG TAB

Prescription Drug - Generic

$1

—

16571030216

GUAIFENESIN AC COUGH SYRUP

Prescription Drug - Generic

$0

—

16571030316

POTASSIUM CL 10% (40 MEQ/30 ML) LIQUID

Prescription Drug - Generic

$0

—

16571030416

POTASSIUM CL 20% (40 MEQ/15 ML

Prescription Drug - Generic

$0

—

16571040110

CETIRIZINE HCL 5 MG TABLET

Prescription Drug - Generic

$0

—

16571066201

MECLIZINE 50 MG TABLET

Prescription Drug - Generic

$2

—

16571068614

CLOTRIMAZOLE 10 MG LOZENGE

Prescription Drug - Generic

$0

—

16571068901

CARBIDOPA-LEVODOPA-ENTACAPONE 12.5-50-200 MG TAB

Prescription Drug - Generic

$1

—

16571069001

CARBIDOPA-LEVODOPA-ENTACAPONE 18.75-75-200 MG TAB

Prescription Drug - Generic

$1

—

My Cost List