Page 75 - Appendices for Eric Hartman
P. 75
ESTIMATED TOTAL MONTHLY DRUG COST
CVS Pharmacy Walgreens Mail Order
#09373 #12140 Pharmacy
In-network In-network In-network
January $10.00 $7.60 $0.00
February $0.00 $0.00 -
March $10.00 $7.60 -
April $0.00 $0.00 $0.00
May $10.00 $7.60 -
June $0.00 $0.00 -
July $10.00 $7.60 $0.00
August $0.00 $0.00 -
September $10.00 $7.60 -
October $0.00 $0.00 $0.00
November $10.00 $7.60 -
December $0.00 $0.00 -
