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Other network providers (Tier 3) - 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

12383

Other network 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

12384

Infertility services prior to March 1, 2020

Member for

7 years 4 months

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

Service Benefit Category Id

12386

Infertility services on and after March 1, 2020

Member for

7 years 4 months

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

Service Benefit Category Id

12387

Blue Distinction Centers and Blue Distinction Centers+ for selected specialty care

Member for

7 years 4 months

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

Service Benefit Category Id

12388

Transportation and lodging for selected specialty care

Member for

7 years 4 months

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

Service Benefit Category Id

12389

Diabetic devices and supplies

Member for

7 years 4 months

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

Service Benefit Category Id

12390

Gene therapies excluded

Member for

7 years 4 months

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

Service Benefit Category Id

12392

Tier 1 Benefits

Member for

7 years 4 months

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

Service Benefit Category Id

12438

Tier 2 Benefits

Member for

7 years 4 months

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

Service Benefit Category Id

12439