Page 48 - APPENDICES for Vic Bosiger
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ESTIMATED TOTAL MONTHLY DRUG COST
CVS Pharmacy #07948
Standard in-network pharmacy
January $170.12
February $170.12
March $346.97
April $428.12
May $428.12
June $428.12
July $383.82
August $123.57
September $123.57
October $123.57
November $123.57
December $123.57
ESTIMATED DRUG COSTS DURING COVERAGE PHASES
