Medication HCPCS Code Price
AMOXicillin 400 Mg/5 ML Susp Oral Syr $8.25
AMOXicillin-CLAV 600 Mg/5 ML Oral Syr $17.10
AMOXicillin-CLAVULAN (80 mg/ml) Oral Syringe $21.20
AMOXicillin-CLAVULANATE 500 Mg Tab $22.35
AMOXicillin-CLAVULANATE 875 Mg Tab $27.75
Amphetamine-Dextroamphet 10 Mg Tab $13.50
Amphetamine-Dextroamphet 20 Mg Tab $14.95
Amphetamine-Dextroamphet XR 10 Mg Cap $36.30
Amphetamine-Dextroamphet XR 30 Mg Cap $36.30
Amphetamine-Dextroamphet XR 5 Mg Cap $32.40