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Cost Estimator
Dahl Memorial
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Cash Pricing
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Medication
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You may need to get a specific service code from your provider.
Code
Description
NEOMYCIN/POLYMIXIN/HC OTIC SOLN
NICOTINE TRANSDERMAL 21 MG/24 HR PATCH
RHC 0.5% BUPIVACAINE INJ 30 ML
RHC ACETAMINOPHEN 120 MG SUPP
RHC ACETAMINOPHEN 160 MG/5 ML ORAL SUSP
RHC ACETAMINOPHEN 325 MG TAB
RHC BUDESONIDE 0.5MG/2ML NEB SOLN
RHC CEFTRIAXONE 500 MG INJ
RHC DEXAMETHASONE 4MG/ML INJ
RHC DIPHENHYDRAMINE 50 MG/ML INJ
RHC IBUPROFEN 200 MG TAB
RHC LIDOCAINE 1% 10 MG/ML INJ - 50 ML
RHC LIDOCAINE W/EPI 1%/1:100000 INJ 20ML
RHC METHYLPREDNISOLONE 125 MG/2ML INJ
RHC PNEUMO 13-VALENT CONJ VACC 0.5 ML
RHC POTASSIUM CHLORIDE ER 10 MEQ TAB
RHC PROMETHAZINE 25MG/ML INJ
90674
RHC FLUCELVAX QUADRIVALENT 23-24 0.5 ML
90694
RHC FLUAD QUADRIVALENT 23-24 0.5 ML
90714
RHC TETANUS-DIPHTHERIA TOXOIDS Td 0.5 ML
90732
RHC PNEUMOCOCCAL 23 VACC INJ 0.5 ML
90746
RHC HEPATITIS B 20 MCG/ML INJ VACC
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