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Steerage 5

Member for

7 years 4 months

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

Service Benefit Category Id

11936

Steerage 7

Member for

7 years 4 months

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

Service Benefit Category Id

11938

Other 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

11943

PPO providers except Designated Facilities (Tier 1)

Member for

7 years 4 months

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

Service Benefit Category Id

11986

Designated Facilities (Tier 2)

Member for

7 years 4 months

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

Service Benefit Category Id

11989

Other PPO providers (Tier 2) - facility services

Member for

7 years 4 months

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

Service Benefit Category Id

11998

Other PPO providers (Tier 2) - facility services

Member for

7 years 4 months

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

Service Benefit Category Id

12000

Physician and other covered professional provider services

Member for

7 years 4 months

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

Service Benefit Category Id

12009

Wayfair PPO providers (Tier 1) - facility services

Member for

7 years 4 months

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

Service Benefit Category Id

12010

Other PPO providers (Tier 2) - facility services

Member for

7 years 4 months

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

Service Benefit Category Id

12011