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Retail - Tier 5

Member for

5 years 10 months
Submitted by ssimhadhri on Thu, 07/15/2021 - 00:54
  • Read more about Retail - Tier 5

Retail - Tier 4

Member for

5 years 10 months
Submitted by ssimhadhri on Thu, 07/15/2021 - 00:54
  • Read more about Retail - Tier 4

Necessary and appropriate orthodontic Services

Member for

5 years 10 months
Submitted by ssimhadhri on Thu, 07/15/2021 - 00:54
  • Read more about Necessary and appropriate orthodontic Services

Diabetes management services

Member for

5 years 10 months
Submitted by ssimhadhri on Thu, 07/15/2021 - 00:54
  • Read more about Diabetes management services

Basic Restorative Services - Other Members

Member for

5 years 10 months
Submitted by ssimhadhri on Thu, 07/15/2021 - 00:54
  • Read more about Basic Restorative Services - Other Members

Designated retail pharmacies

Member for

5 years 10 months
Submitted by ssimhadhri on Thu, 07/15/2021 - 00:54
  • Read more about Designated retail pharmacies

Major Restorative Services - Members Eligible for Pediatric Essential Benefits

Member for

5 years 10 months
Submitted by ssimhadhri on Thu, 07/15/2021 - 00:54
  • Read more about Major Restorative Services - Members Eligible for Pediatric Essential Benefits

Tier 4 covered drugs

Member for

5 years 10 months
Submitted by ssimhadhri on Thu, 07/15/2021 - 00:54
  • Read more about Tier 4 covered drugs

Participating retail pharmacy - Tier 3 (30-day supply)

Member for

5 years 10 months
Submitted by ssimhadhri on Thu, 07/15/2021 - 00:54
  • Read more about Participating retail pharmacy - Tier 3 (30-day supply)

Participating retail pharmacy - Tier 2 (30-day supply)

Member for

5 years 10 months
Submitted by ssimhadhri on Thu, 07/15/2021 - 00:54
  • Read more about Participating retail pharmacy - Tier 2 (30-day supply)

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