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Other PPO providers (Tier 3) - inpatient professional (physician) services

Member for

7 years 4 months

Submitted by Site Factory admin on Wed, 01/13/2021 - 00:11

Service Benefit Category Id

12109

Other PPO providers (Tier 3) - inpatient hospital or facility services

Member for

7 years 4 months

Submitted by Site Factory admin on Wed, 01/13/2021 - 00:11

Service Benefit Category Id

12114

Other PPO providers (Tier 3) - inpatient professional (physician) services

Member for

7 years 4 months

Submitted by Site Factory admin on Wed, 01/13/2021 - 00:11

Service Benefit Category Id

12115

Steward Providers and Steward Affiliates (Tier 1) - hospital or facility respiratory services

Member for

7 years 4 months

Submitted by Site Factory admin on Wed, 01/13/2021 - 00:11

Service Benefit Category Id

12120

Steward approved PPO providers (Tier 2) - professional (physician) respiratory services

Member for

7 years 4 months

Submitted by Site Factory admin on Wed, 01/13/2021 - 00:11

Service Benefit Category Id

12124

Do not use 1

Member for

7 years 4 months

Submitted by Site Factory admin on Wed, 01/13/2021 - 00:11

Service Benefit Category Id

12128

Steward Providers and Steward Affiliates (Tier 1)

Member for

7 years 4 months

Submitted by Site Factory admin on Wed, 01/13/2021 - 00:11

Service Benefit Category Id

12143

Steward Providers and Steward Affiliates (Tier 1)

Member for

7 years 4 months

Submitted by Site Factory admin on Wed, 01/13/2021 - 00:11

Service Benefit Category Id

12149

Steward approved PPO providers (Tier 2)

Member for

7 years 4 months

Submitted by Site Factory admin on Wed, 01/13/2021 - 00:11

Service Benefit Category Id

12150

Other PPO providers (Tier 3)

Member for

7 years 4 months

Submitted by Site Factory admin on Wed, 01/13/2021 - 00:11

Service Benefit Category Id

12154