Member for 8 years Submitted by Site Factory admin on Thu, 08/21/2025 - 00:53 Covered Service Text 12374 12108 194 12109 12375 196 197 198 199 200 202 203 11938 12420 11398 13425 Plan ID 10082 Plan Name PPO Student Health Plan Product Type Medical Service Benefit Category Id 33 Service Benefit Category Name Routine Pediatric Care
