div class=ts-pagebutton class=gotoPage data-page=1Page 1button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=1 data-page=1 class=ts-thumb lazyload alt=Page 1: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails1jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=2Page 2button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=2 data-page=2 class=ts-thumb lazyload alt=Page 2: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails2jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=3Page 3button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=3 data-page=3 class=ts-thumb lazyload alt=Page 3: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails3jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=4Page 4button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=4 data-page=4 class=ts-thumb lazyload alt=Page 4: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails4jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=5Page 5button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=5 data-page=5 class=ts-thumb lazyload alt=Page 5: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails5jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=6Page 6button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=6 data-page=6 class=ts-thumb lazyload alt=Page 6: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails6jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=7Page 7button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=7 data-page=7 class=ts-thumb lazyload alt=Page 7: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails7jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=8Page 8button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=8 data-page=8 class=ts-thumb lazyload alt=Page 8: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails8jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=9Page 9button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=9 data-page=9 class=ts-thumb lazyload alt=Page 9: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails9jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=10Page 10button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=10 data-page=10 class=ts-thumb lazyload alt=Page 10: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails10jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=11Page 11button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=11 data-page=11 class=ts-thumb lazyload alt=Page 11: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails11jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=12Page 12button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=12 data-page=12 class=ts-thumb lazyload alt=Page 12: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails12jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=13Page 13button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=13 data-page=13 class=ts-thumb lazyload alt=Page 13: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails13jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=14Page 14button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=14 data-page=14 class=ts-thumb lazyload alt=Page 14: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails14jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=15Page 15button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=15 data-page=15 class=ts-thumb lazyload alt=Page 15: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails15jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=16Page 16button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=16 data-page=16 class=ts-thumb lazyload alt=Page 16: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails16jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=17Page 17button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=17 data-page=17 class=ts-thumb lazyload alt=Page 17: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails17jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=18Page 18button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=18 data-page=18 class=ts-thumb lazyload alt=Page 18: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails18jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=19Page 19button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=19 data-page=19 class=ts-thumb lazyload alt=Page 19: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails19jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=20Page 20button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=20 data-page=20 class=ts-thumb lazyload alt=Page 20: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails20jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=21Page 21button div class=ts-imageimg data-url=medicare-vd-0-combined-1-1-17-express-scripts-scripts-male-value-pa-er-usahtmlpage=21 data-page=21 class=ts-thumb lazyload alt=Page 21: Medicare vD 0 Combined 1 1 17 - Express Scripts · Scripts male Value Pa er Usa e 3Ø7-C7 Place of Service ØI = Pharma 322-CM 323-CN 324-co Patient Street Address Patient Ci Patient loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentinreader030viewer20220218085c44813f93f3c34c323257b9html5thumbnails21jpg width=140 height=200 divdiv
