Page 96 - APPENDICES for Diane Falten
P. 96
An official website of the United States government
Here's how you know
Armour Thyroid is not included in the list
below because the Medicare Plan Finder Menu
does include it as a covered drug.
Amlodipine 5mg tablet Quantity Frequency
generic 30 Every month
Atorvastatin 20mg tablet Quantity Frequency
generic 30 Every month
Losartan potassium 100mg may require your Quantity Frequency
tablet physician's prior 30 Every month
generic authorization for it
to be covered.
Memantine hydrochloride 5mg Quantity Frequency
tablet 30 Every month
generic
Metformin hydrochloride Quantity Frequency
1000mg tablet 30 Every month
generic
Omeprazole 40mg capsule Quantity Frequency
delayed release 30 Every month
generic
Trazodone hydrochloride 50mg Quantity Frequency
tablet 30 Every month
generic
