DRUG NAME PRICE DRUG NAME PRICE
Amoxicillin, 500 mg. #30 8.00 Ttriamcinolone 7.00
Amoxicillin Clav Acid, 875 mg. #20 27.00 Valtrex 500 mg. #10 76.00
Antibiotic Ear Solution, 10 ml. 17.00 Lidocaine, 1% 5 ml N/C
(Hydrocortisone/Neomycin B) Ondansetron 8 mg. 26.00
Azithromycin, 250 mg. #6 13.00 (Zofran-Oral dissolving tablet)
Azithromycin, 250 mg. #4 19.00 Suprax, tablet 17.00
Bacitracin 8.00
Benzamycin Pak, Top gel 60 5%/3% 129.00
Benzonatate 100 mg. #20 9.00
Betamethasone, 0.1% ointment 7.00
Ceftriaxzone, 250 mg. IM 9.00
Cephalexin, 500 mg. #20 9.00 Discontinued: Elimite Cream5%, 60 gms. 74.00 Silvadene
Cetirizine Hydrochloride10 mg. #30 8.00
Ciprofloxacin, 500 mg. #6 7.00
Ciprofloxacin, 500 mg. #20 9.00
Clotrimazole 1% Vag Cream 11.00
Cyclobenzaprine 5 mg. #30 9.00
Doxycycline, 100 mg. #20 8.00
Ear Antibiotic Suspension 16.00
Erythromycin opth.oint. 3.5 gm 8.00
Erythromycin topical soln. 60 ml. 15.00
Fexofenadine, 180 mg. #30 39.00
Fluconazole, 150 mg. #1 7.00
Fluticasone Nasal Spray 14.00
Generic Lice-Aid Shampoo 13.00
Isoniazid (INH) 300 mg. #100 12.00
Ketoconazole, 30 gm. (Nizoral) 16.00
Metronidazole, 500 mg. #14 7.00
Naproxen Sodium 500 mg. #20 7.00
Nitrofurantoin, 100 mg. #14 13.00
Penicillin VK, 500 mg. #20 10.00
Phenazopyridine #9 7.00
Polymyxin B Ophthalmic Soln. 8.00
Prednisone, 20 mg. #21 8.00
Pro Air 44.00
Pulmicort Flex-haler, 180 mcg. 140.00
Ranitidine 150 mg. #60 8.00
Retin A Micro Gel, 0.1% 45 gm. 156.00
SMZ/TMP, DS, #20 7.00
SMZ/TMP, DS, #6 7.00
Selenium Sulfide, 2.5%, 4 oz. 12.00
Tamiflu, 75 mg. #10 tabs. 101.00
Terazol 3 Cream 20 gm tube 59.00
Tetracycline, 500 mg. #100 12.00
Tretinoin, 0.025%, 20 gm 18.00
Contraceptives
DRUG NAME PRICE
Depo Provera 85.00
Levora, 28 day 24.00
Lutera, 28 24.00
Nuva Ring 52.00
Ortho Tricyclen Lo 42.00
Plan B 23.00
Trinessa, 28 day (Tricyclen) 24.00
LoEstrin 24 Fe 10.00
Vaccines
DRUG NAME PRICE
Adacel (Tdap) 42.00
Flu Vaccine 15.00
Gardasil 5822-00 144.00
Havrix (Hep A) 72.00
MMR 59.00
Menactra (Meningococcal) 98.00
Oral Typhoid 48.00
Recombivax (Hep B) 55.00
Tetanus Diphtheria 25.00
IPOL, Inactivated Polio, 30.00
Typhim VI, injection 59.00
Energix B, pediatric dose 29.00
Energix B, adult dose 34.00
H1N1 flu vaccine 0.00
Medical Supplies
Ankle Air Cast 38.00
Crutches 40.00
Canes 18.00
Wrist splints 15.00
Revenue
Health Form Completion Fee..................................................85.00
Miscellaneous Revenue...........................................................Open
Medical Records.................................................................... Open
Fee-for-Service Visits -- New/FU.............................................50/30
Pls/LZ Revised: 2/25/2009; 6/25/2009; 9/1/2009. Prices subject to change.