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| Pharmacy Drug |
Dosage |
Quantity |
Member Price |
Unit Price |
|
| Juvederm |
2 syr/1 box |
5 |
$1345.00 |
$269.00 |
 |
| Juvederm |
2 syr/1 box |
10 |
$2699.00 |
$269.90 |
|
| Juvederm |
2 syr/1 box |
1 |
$275.00 |
$275.00 |
|
| Juvederm |
2 syr/1 box |
5 |
$1389.00 |
$277.80 |
|
| Juvederm |
2 syr/1 box |
10 |
$2778.00 |
$277.80 |
|
| Juvederm |
2 syr/1 box |
1 |
$294.00 |
$294.00 |
|
| Juvederm |
2 syr/1 box |
10 |
$3399.00 |
$339.90 |
|
| Juvederm |
2 syr/1 box |
10 |
$3689.00 |
$368.90 |
|
| Juvederm |
2 syr/1 box |
10 |
$3699.00 |
$369.90 |
|
| Juvederm |
2 syr/1 box |
5 |
$1859.00 |
$371.80 |
|
|
