Medical Procedure Costs

24208079062

NEOMYC-POLYM-GRAMICID EYE DROP

Prescription Drug - Generic

$4

—

24208080060

LACRISERT 5 MG EYE INSERT

Prescription Drug - Brand

$8

—

24208091112

XIIDRA 5% EYE DROPS

Prescription Drug - Brand

$12

—

24208092064

TETRACAINE 0.5% EYE DROPS

Prescription Drug - Generic

$1

—

24220

Injection px for elbow arthg

Surgery - Musculoskeletal

$56

—

24300

Mnpj elbow under anes

Surgery - Musculoskeletal

$446

—

24301

Musc/tdn transfer upr a/e 1

Surgery - Musculoskeletal

$701

—

24305

Tendon lngth upr a/e ea tdn

Surgery - Musculoskeletal

$541

—

24310

Tnot opn elbw to sho ea tdn

Surgery - Musculoskeletal

$442

—

24320

Tenoplasty elbow to sho 1

Surgery - Musculoskeletal

$729

—

24330

Flexor-plasty elbow

Surgery - Musculoskeletal

$677

—

24331

Flexor-plasty elbw w/advmnt

Surgery - Musculoskeletal

$734

—

24332

Tenolysis triceps

Surgery - Musculoskeletal

$590

—

24338001009

BIDIL 20 MG-37.5 MG TABLET

Prescription Drug - Brand

$4

—

24338001018

BIDIL TABLET

Prescription Drug - Brand

$4

—

24338001690

ADTHYZA 16.25 MG TABLET

Prescription Drug - Brand

$1

—

24338002010

EVEKEO 5 MG TABLET

Prescription Drug - Brand

$6

—

24338002603

EVEKEO 10 MG TABLET

Prescription Drug - Brand

$8

—

24338003290

ADTHYZA 32.5 MG TABLET

Prescription Drug - Brand

$1

—

24338003301

EVEKEO ODT 10 MG

Prescription Drug - Brand

$7

—

24338006590

ADTHYZA 65 MG TABLET

Prescription Drug - Brand

$1

—

24338008014

OTOVEL 0.3%-0.025% EAR DROPS

Prescription Drug - Brand

$17

—

24338009790

ADTHYZA 97.5 MG TABLET

Prescription Drug - Brand

$1

—

24338010013

E.E.S. 400 FILMTAB

Prescription Drug - Generic

$10

—

24338010620

ERYTHROCIN 250 MG FILMTAB

Prescription Drug - Brand

$10

—

24338011013

ERYTHROMYCIN ES 400 MG TAB

Prescription Drug - Generic

$12

—

24338012013

ERYTHROMYCIN EC 250 MG CAP

Prescription Drug - Generic

$4

—

24338012203

ERY-TAB DR 250 MG TABLET

Prescription Drug - Generic

$2

—

24338012213

ERY-TAB EC 250 MG TABLET

Prescription Drug - Generic

$7

—

24338012403

ERY-TAB DR 333 MG TABLET

Prescription Drug - Generic

$3

—

24338012413

ERY-TAB EC 333 MG TABLET

Prescription Drug - Generic

$9

—

24338012603

ERY-TAB DR 500 MG TABLET

Prescription Drug - Generic

$3

—

24338012613

ERY-TAB EC 500 MG TABLET

Prescription Drug - Generic

$9

—

24338013013

ERYPED 400 MG/5 ML SUSPENSION

Prescription Drug - Brand

$6

—

24338013213

ERYPED 200 MG/5 ML SUSPENSION

Prescription Drug - Brand

$4

—

24338013402

E.E.S. 200 MG/5 ML GRANULES

Prescription Drug - Brand

$4

—

24338018504

SKLICE 0.5% LOTION

Prescription Drug - Brand

$0

—

24338030020

NITROLINGUAL 0.4 MG SPRAY

Prescription Drug - Brand

$31

—

24338053048

SOTYLIZE 5 MG/ML ORAL SOLUTION

Prescription Drug - Brand

$2

—

24338085110

ZENZEDI 5 MG TABLET

Prescription Drug - Generic

$2

—

24338085310

ZENZEDI 10 MG TABLET

Prescription Drug - Generic

$2

—

24338085603

ZENZEDI 30 MG TABLET

Prescription Drug - Brand

$10

—

24340

Tenodesis biceps tdn at elbw

Surgery - Musculoskeletal

$584

—

24341

Rpr tdn/musc upr a/e each

Surgery - Musculoskeletal

$708

—

24342

Repair of ruptured tendon

Surgery - Musculoskeletal

$716

—

24343

Repr elbow lat ligmnt w/tiss

Surgery - Musculoskeletal

$677

—

24344

Reconstruct elbow lat ligmnt

Surgery - Musculoskeletal

$1,030

—

24345

Repr elbw med ligmnt w/tissu

Surgery - Musculoskeletal

$675

—

24346

Reconstruct elbow med ligmnt

Surgery - Musculoskeletal

$1,030

—

24357

Repair elbow perc

Surgery - Musculoskeletal

$384

—

My Cost List