COVERAGESTAGE
CATASTROPHIC
COVERAGEGAP
COINSURANCE
DEDUCTIBLE
PREFERRED
WALGREENS
PHARMACY
INITIAL
NETWORK
OPTUMRX
GENERIC
COPAY
BRAND
TIER
I
A
E
U
D
C
O
V
E
R
A
G
E
G
A
P
A
O
J
A
P
K
B
E
D
T
U
U
U
V
E
V
C
O
O
O
K
Z
Y
H
T
R
D
N
E
V
A
B
F
E
C
A
Y
A
R
I
U
A
A
I
A
U
V
G
Y
S
A
D
G
Z
T
A
X
E
W
B
G
R
E
N
C
H
A
A
L
U
V
W
T
A
P
U
G
O
B
V
M
U
D
T
U
T
A
T
C
K
A
W
S
O
A
W
P
O
E
A
B
E
I
X
S
O
J
J
J
O
I
T
C
O
M
Z
E
Y
C
I
C
B
U
E
P
R
E
F
E
R
R
E
D
P
W
Y
H
Y
L
N
L
S
G
H
E
V
H
S
O
O
F
O
I
D
S
S
S
U
A
E
C
A
U
I
L
P
N
E
P
O
C
Z
A
I
K
U
G
R
S
N
R
B
W
A
E
E
W
H
A
A
A
Y
M
R
F
K
U
W
A
E
U
S
A
C
E
Y
I
S
A
Q
O
O
O
E
V
S
O
N
V
D
I
A
O
R
L
C
F
U
Q
P
E
W
U
L
N
P
O
O
K
N
E
O
G
A
Q
C
M
I
I
H
T
H
X
I
T
U
C
Q
Z
O
O
L
I
H
I
D
F
W
G
E
I
M
O
U
O
E
A
C
H
G
A
E
E
U
H
W
U
O
N
G
A
C
M
A
Z
L
Z
W
W
W
C
A
A
T
I
E
R
X
O
F
T
R
I
N
I
T
I
A
L
A
U
O
T
Y
R
E
Q
Y
B
Y
X
W
S
U
A
G
E
N
E
R
I
C
H
R
O
