Page 52 - Appendices for Eric Hartman
P. 52
ESTIMATED TOTAL MONTHLY DRUG COST
CVS Pharmacy Walgreens Mail Order
#09373 #12140 Pharmacy
Preferred In-network Preferred
January $0.00 $33.55 $0.00
February $0.00 $21.00 -
March $0.00 $33.55 -
April $0.00 $21.00 $0.00
May $0.00 $33.55 -
June $0.00 $21.00 -
July $0.00 $33.55 $0.00
August $0.00 $21.00 -
September $0.00 $33.55 -
October $0.00 $21.00 $0.00
November $0.00 $33.55 -
December $0.00 $21.00 -
