Member for 7 years 1 month Submitted by Site Factory admin on Fri, 10/20/2023 - 18:46 Covered Service Text 11042 12962 12428 13112 12835 77 12963 78 79 13120 11570 80 82 13123 84 86 12491 13134 11893 Plan ID 10062 Plan Name Preferred Blue PPO Deductible Product Type Medical Service Benefit Category Id 19 Service Benefit Category Name Medical Care Outpatient Visits
