Page 5 - Evaluation for Dirk Huybrechts
P. 5
9/12/2017 My Drug List
Medicare Plan Finder I entered 10 tablets
per month for this
My Drug List drug, which you
take on an as-
Your Name: ____________________ needed basis. It's
Date: 9/12/2017 an inexpensive
drug and changes
Drug List ID: 0226651648 in monthly
Password Date: 9/12/2017 quantities won't
have much effect
Zip Code: 90049 on the price.
Total Drugs in My Drug List: 2
My Drug List
Medicine Name Quantity Frequency & Pharmacy Generic Options
Every 1 Month
Pravastatin Sodium TAB 20MG 30 Already Generic
Retail Pharmacy
Every 1 Month
Zolpidem Tartrate TAB 10MG 10 Already Generic
Retail Pharmacy
https://plancompare.medicare.gov/pfdn/Modules/DRX.Modules.PlanCompare/PopUp/PrintDrugList?PlanFinderDRxIntegrationId=ff17f62d95b946328ff… 1/1
