Page 11 - Cover Letter and Cost Estimates for Ms. LaVerne Durham
P. 11
Client Data Sheet
Client ID: 630215 Rx Password Date: August 6, 2021
Please verify the accuracy of the information below and let us know if
To the Client:
changes need to be made.
Client's DOB: NA
Date that Medicare became or will become primary (when client
has both Part A & Part B): NA
Client's home zip code: 20904
Has client started receiving Social Security or SSDI payments? NA
After client retires, will he or she have access to health insurance
through a spouse's or ex-spouse's employer plan? NA
Client's Selection Criteria
Clients wants to have estimates of Medicare costs
Prescription Drugs
5
