Page 65 - Appendices to Donald Pender's Evaluation
P. 65
MY DRUG LIST
Package Quantity Frequency Brand/Generic
Dutasteride 0.5mg Every
capsule 30 month Generic
PART B DRUGS
These are drugs you usually get at a doctor's o ce or hospital outpatient setting, like the u shot,
chemotherapy, or other shots.
Chemotherapy drugs 20% coinsurance Limits apply
Other Part B drugs 20% coinsurance Limits apply
Extra bene ts
HEARING
Hearing exam $0 copay Limits apply
Fitting/evaluation $0 copay Limits apply
Hearing aids - all types $0 copay Limits apply
