Page 121 - Cover Letter and Evaluation for Anne Ellzey

11/8/2017 Your Medicare Health Plan Details
MEDICINE NAME QUANTITY FREQUENCY & GENERIC OPTIONS ACTION
PHARMACY
30 Every 1 Month Already Generic R Add
Change doseemove
Retail
Pharmacy

Change dose Add
HYDROCODONE/ACETAMINOPHEN TAB 5- 30 Every 2 Months Already Generic Remove
300MG
Retail
Pharmacy

Change dose Add
LAMOTRIGINE TAB 150MG 60 Every 1 Month Already Generic Remove
Retail
Pharmacy

Change dose Add
LOSARTAN POTASSIUM TAB 25MG 30 Every 1 Month Already Generic Remove
Retail
Pharmacy

Change dose Add

LYRICA CAP 50MG 90 Every 1 Month Generic Not Available Remove
Retail
Pharmacy

Change dose Add

MELOXICAM TAB 7.5MG 60 Every 2 Months Already Generic Remove
Retail
Pharmacy

Change dose Add
SUMATRIPTAN SPR 20MG/ACT 12 X 1 Every 2 Months Already Generic Remove
Inhaler (sold Retail
in a package Pharmacy
of 6)

Change dose Add

VENLAFAXINE HCL TAB 150MG ER 30 Every 1 Month Already Generic Remove
Retail
Pharmacy

Change dose Add

ZOLPIDEM TARTRATE TAB 10MG 30 Every 1 Month Already Generic Remove
Retail
Pharmacy

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