Page 74 - Appendices for Eric Hartman
P. 74
ESTIMATED TOTAL DRUG + PREMIUM COST
CVS Pharmacy Walgreens Mail Order
#09373 #12140 Pharmacy
In-network In-network In-network
Total yearly drug +
$60.00 $45.60 $0.00
premium cost
When you'll enter
the coverage gap
You won't enter You won't enter You won't enter
the coverage gap the coverage gap the coverage gap
in 2023 in 2023 in 2023
