Page 98 - Appendices for Eric Hartman
P. 98
ESTIMATED TOTAL DRUG + PREMIUM COST
CVS Pharmacy Walgreens #12140 Mail Order
#09373 Pharmacy
Out-of-network
Preferred Preferred
Total yearly drug +
$139.56 $3,145.26 $134.04
premium cost
You won't meet You won't meet
When you'll meet
your deductible your deductible March 2023 your deductible
in 2023 in 2023
You won't enter You won't enter
When you'll enter the coverage gap You won't enter the the coverage gap
the coverage gap coverage gap in 2023
in 2023 in 2023
