Page 88 - Evaluation for Dirk Huybrechts
P. 88

9/12/2017                                       Your Medicare Health Plan Details
            MEDICINE NAME                 QUANTITY     FREQUENCY &     GENERIC OPTIONS     ACTION
                                                       PHARMACY


                                                                                            Change dose  Add
            ZOLPIDEM TARTRATE TAB 10MG    10           Every 1 Month   Already Generic      Remove
                                                       Retail Pharmacy







          Return to previous page









































































      https://www.medicare.gov/find-a-plan/results/planresults/plan-details.aspx?cntrctid=H5521&plnid=125&sgmntid=0#plan_drug_cost  3/3
   83   84   85   86   87   88   89   90