Member for 7 years 1 month Submitted by Site Factory admin on Fri, 10/20/2023 - 18:46 Covered Service Text 11042 12962 12428 12835 77 78 79 13120 11570 80 82 13123 84 86 12491 11856 Plan ID 10016 Plan Name Blue Care Elect Preferred 80 with Copay Product Type Medical Service Benefit Category Id 19 Service Benefit Category Name Medical Care Outpatient Visits