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Tier 4 covered drugs

Member for

7 years 5 months

Submitted by Site Factory admin on Wed, 01/13/2021 - 00:10

Service Benefit Category Id

11232

Medicamentos cubiertos del Nivel 4

Member for

7 years 5 months

Submitted by Site Factory admin on Wed, 01/13/2021 - 00:10

Service Benefit Category Id

11232

Major Restorative Services - Members Eligible for Pediatric Essential Benefits

Member for

7 years 5 months

Submitted by Site Factory admin on Wed, 01/13/2021 - 00:10

Service Benefit Category Id

11235

Servicios de restauración de envergadura - Miembros elegibles para beneficios pediátricos esenciales

Member for

7 years 5 months

Submitted by Site Factory admin on Wed, 01/13/2021 - 00:10

Service Benefit Category Id

11235

With Choice PCP

Member for

7 years 5 months

Submitted by Site Factory admin on Wed, 01/13/2021 - 00:10

Service Benefit Category Id

11307

Con PCP de Choice

Member for

7 years 5 months

Submitted by Site Factory admin on Wed, 01/13/2021 - 00:10

Service Benefit Category Id

11307

With Choice PCP

Member for

7 years 5 months

Submitted by Site Factory admin on Wed, 01/13/2021 - 00:10

Service Benefit Category Id

11309

Con PCP de Choice

Member for

7 years 5 months

Submitted by Site Factory admin on Wed, 01/13/2021 - 00:10

Service Benefit Category Id

11309

Designated retail pharmacies

Member for

7 years 5 months

Submitted by Site Factory admin on Wed, 01/13/2021 - 00:10

Service Benefit Category Id

11371

Farmacias minoristas designadas

Member for

7 years 5 months

Submitted by Site Factory admin on Wed, 01/13/2021 - 00:10

Service Benefit Category Id

11371