Other PPO providers for members age 19 and older
Service Benefit Category Id
11613
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Partners Preferred Network - office and health center services
Service Benefit Category Id
11614
Other PPO providers for members age 18 and younger - office and health center services
Service Benefit Category Id
11616
Other PPO providers for members age 19 and older - office and health center services
Service Benefit Category Id
11617
Other PPO providers - hospital and other day surgical facility services
Service Benefit Category Id
11618
MIT Medical retail pharmacy (30-day supply)
Service Benefit Category Id
11629
Milford Regional Physician Group
Service Benefit Category Id
11631
Network mail order pharmacy - Value drugs
Service Benefit Category Id
11632
Network mail order pharmacy - Other covered drugs and supplies
Service Benefit Category Id
11633
Orthodontic services for enrolled children until end of calendar month age 26
Service Benefit Category Id
11634