Necessary and appropriate orthodontic Services Member for 5 years 4 months Submitted by ssimhadhri on Thu, 07/15/2021 - 00:54 Read more about Necessary and appropriate orthodontic Services
Diabetes management services Member for 5 years 4 months Submitted by ssimhadhri on Thu, 07/15/2021 - 00:54 Read more about Diabetes management services
Basic Restorative Services - Other Members Member for 5 years 4 months Submitted by ssimhadhri on Thu, 07/15/2021 - 00:54 Read more about Basic Restorative Services - Other Members
Designated retail pharmacies Member for 5 years 4 months Submitted by ssimhadhri on Thu, 07/15/2021 - 00:54 Read more about Designated retail pharmacies
Major Restorative Services - Members Eligible for Pediatric Essential Benefits Member for 5 years 4 months Submitted by ssimhadhri on Thu, 07/15/2021 - 00:54 Read more about Major Restorative Services - Members Eligible for Pediatric Essential Benefits
Tier 4 covered drugs Member for 5 years 4 months Submitted by ssimhadhri on Thu, 07/15/2021 - 00:54 Read more about Tier 4 covered drugs
Participating retail pharmacy - Tier 3 (30-day supply) Member for 5 years 4 months Submitted by ssimhadhri on Thu, 07/15/2021 - 00:54 Read more about Participating retail pharmacy - Tier 3 (30-day supply)
Participating retail pharmacy - Tier 2 (30-day supply) Member for 5 years 4 months Submitted by ssimhadhri on Thu, 07/15/2021 - 00:54 Read more about Participating retail pharmacy - Tier 2 (30-day supply)
Participating retail pharmacy - Tier 1 (30-day supply) Member for 5 years 4 months Submitted by ssimhadhri on Thu, 07/15/2021 - 00:54 Read more about Participating retail pharmacy - Tier 1 (30-day supply)
Other hearing aid dealer (members age 22 and older) Member for 5 years 4 months Submitted by ssimhadhri on Thu, 07/15/2021 - 00:54 Read more about Other hearing aid dealer (members age 22 and older)
