Page 122 - Cover Letter and Evaluation for John

10/9/2018 Your Medicare Health Plan Details
MEDICINE NAME QUANTITY FREQUENCY & GENERIC OPTIONS ACTION
PHARMACY

Change dose
OLMESARTAN 30 Every 1 Month Already Generic Add Remove
MEDOXOMIL/HYDROCHLOROTHIAZIDE TAB Retail (You originally
40-12.5
Pharmacy entered Benicar HCT)
Switch Back

Change dose
OMEGA-3-ACID ETHYL ESTERS CAP 1GM 120 Every 1 Month Already Generic Add Remove
Retail
Pharmacy

Change dose
POTASSIUM CHLORIDE CR 60 Every 1 Month Already Generic Add Remove
(MICROENCAPSULATED) TAB 10MEQ CR
Retail
Pharmacy

Change dose
PRAVASTATIN SODIUM TAB 10MG 30 Every 1 Month Already Generic Add Remove
Retail
Pharmacy

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