Other network Physician and other covered professional provider services
Service Benefit Category Id
11399
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Other network Physician and other covered professional provider services
Service Benefit Category Id
11413
Other network inpatient and outpatient day surgery services
Service Benefit Category Id
11414
Urgent care facility services
Service Benefit Category Id
11418
Retail Select Network - Tier 2
Service Benefit Category Id
11421
Retail pharmacy, including Harvard University Retail pharmacy (30-day supply)
Service Benefit Category Id
11441
Immunizations and injections
Service Benefit Category Id
11443
Do not use (out of order)
Service Benefit Category Id
11446
Steward Providers and Steward Affiliates (Tier 1)
Service Benefit Category Id
11455
Other network providers (Tier 2)
Service Benefit Category Id
11456