Page 41 - APPENDICES for Diane Falten
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ESTIMATED TOTAL MONTHLY DRUG COST
CVS Pharmacy #10463
Preferred Preferred in-network pharmacy
January $10.00
February $10.00
March $10.00
April $10.00
May $10.00
June $10.00
July $10.00
August $10.00
September $10.00
October $10.00
November $10.00
December $10.00
ESTIMATED DRUG COSTS DURING COVERAGE PHASES
