Table 6.
Name of medicine or description of equipment/supplies (e.g., syringes, thermometer) | Amount paid by you | Provided by home care agency. If equipment, borrowed or given to you to keep? | |
---|---|---|---|
Total cost of medicine (including dispensing fee) or supplies/equipment (rented/purchased) | Will you be reimbursed for this money? (yes or no) If yes, indicate % or amount reimbursed |
||
Acetaminophen | $10 | No | No |
Nutritional Drinks | $13 | Yes (90%) | No |