| 92551NY0380099 |
Embrace Health EPO Copayment 221, Gold, NS, INN, Dep25, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380104 |
Embrace Health EPO Copayment 221, Gold, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380100 |
Embrace Health EPO Copayment 221, Gold, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380097 |
Embrace Health EPO Copayment 221, Gold, NS, INN, Dep25, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380101 |
Embrace Health EPO Copayment 221, Gold, NS, INN, Dep29, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380103 |
Embrace Health EPO Copayment 221, Gold, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380102 |
Embrace Health EPO Copayment 221, Gold, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380098 |
Embrace Health EPO Copayment 221, Gold, NS, INN, Dep29, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380908 |
EPO Copay First 425, Silver, NS, INN, Dep25, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380913 |
EPO Copay First 425, Silver, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380909 |
EPO Copay First 425, Silver, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380906 |
EPO Copay First 425, Silver, NS, INN, Dep25, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380910 |
EPO Copay First 425, Silver, NS, INN, Dep29, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380912 |
EPO Copay First 425, Silver, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380911 |
EPO Copay First 425, Silver, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380907 |
EPO Copay First 425, Silver, NS, INN, Dep29, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380003 |
EPO Copayment 120, Platinum, NS, INN, Dep25, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380008 |
EPO Copayment 120, Platinum, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380004 |
EPO Copayment 120, Platinum, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380001 |
EPO Copayment 120, Platinum, NS, INN, Dep25, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380005 |
EPO Copayment 120, Platinum, NS, INN, Dep29, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380007 |
EPO Copayment 120, Platinum, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380006 |
EPO Copayment 120, Platinum, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380002 |
EPO Copayment 120, Platinum, NS, INN, Dep29, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380788 |
EPO Copayment 121, Platinum, NS, INN, Dep25, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380793 |
EPO Copayment 121, Platinum, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380789 |
EPO Copayment 121, Platinum, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380786 |
EPO Copayment 121, Platinum, NS, INN, Dep25, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380790 |
EPO Copayment 121, Platinum, NS, INN, Dep29, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380792 |
EPO Copayment 121, Platinum, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380791 |
EPO Copayment 121, Platinum, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380787 |
EPO Copayment 121, Platinum, NS, INN, Dep29, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380812 |
EPO Copayment 130, Platinum, NS, INN, Dep25, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380817 |
EPO Copayment 130, Platinum, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380813 |
EPO Copayment 130, Platinum, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380810 |
EPO Copayment 130, Platinum, NS, INN, Dep25, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380814 |
EPO Copayment 130, Platinum, NS, INN, Dep29, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380816 |
EPO Copayment 130, Platinum, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380815 |
EPO Copayment 130, Platinum, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380811 |
EPO Copayment 130, Platinum, NS, INN, Dep29, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380019 |
EPO Copayment 220, Gold, NS, INN, Dep25, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380024 |
EPO Copayment 220, Gold, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380020 |
EPO Copayment 220, Gold, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380017 |
EPO Copayment 220, Gold, NS, INN, Dep25, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380021 |
EPO Copayment 220, Gold, NS, INN, Dep29, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380023 |
EPO Copayment 220, Gold, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380022 |
EPO Copayment 220, Gold, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380018 |
EPO Copayment 220, Gold, NS, INN, Dep29, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380916 |
EPO Hybrid 226 Gold, NS, INN, Dep25, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380921 |
EPO Hybrid 226 Gold, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380917 |
EPO Hybrid 226 Gold, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380914 |
EPO Hybrid 226 Gold, NS, INN, Dep25, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380918 |
EPO Hybrid 226 Gold, NS, INN, Dep29, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380920 |
EPO Hybrid 226 Gold, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380919 |
EPO Hybrid 226 Gold, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380915 |
EPO Hybrid 226 Gold, NS, INN, Dep29, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380932 |
EPO Triple Zero Copayment 227, Gold, NS, INN, Dep25, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380937 |
EPO Triple Zero Copayment 227, Gold, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380933 |
EPO Triple Zero Copayment 227, Gold, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380930 |
EPO Triple Zero Copayment 227, Gold, NS, INN, Dep25, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380934 |
EPO Triple Zero Copayment 227, Gold, NS, INN, Dep29, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380936 |
EPO Triple Zero Copayment 227, Gold, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380935 |
EPO Triple Zero Copayment 227, Gold, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380931 |
EPO Triple Zero Copayment 227, Gold, NS, INN, Dep29, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380924 |
HDEPO EPC 332 Silver, NS, INN, Dep25, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380929 |
HDEPO EPC 332 Silver, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380925 |
HDEPO EPC 332 Silver, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380922 |
HDEPO EPC 332 Silver, NS, INN, Dep25, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380926 |
HDEPO EPC 332 Silver, NS, INN, Dep29, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380928 |
HDEPO EPC 332 Silver, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380927 |
HDEPO EPC 332 Silver, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380923 |
HDEPO EPC 332 Silver, NS, INN, Dep29, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380884 |
HDEPO HSA Qualified 225, Gold, NS, INN, Dep25, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380889 |
HDEPO HSA Qualified 225, Gold, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380885 |
HDEPO HSA Qualified 225, Gold, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380882 |
HDEPO HSA Qualified 225, Gold, NS, INN, Dep25, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380886 |
HDEPO HSA Qualified 225, Gold, NS, INN, Dep29, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380888 |
HDEPO HSA Qualified 225, Gold, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380887 |
HDEPO HSA Qualified 225, Gold, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380883 |
HDEPO HSA Qualified 225, Gold, NS, INN, Dep29, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380387 |
HDEPO HSA Qualified 320, Silver, NS, INN, Dep25, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380392 |
HDEPO HSA Qualified 320, Silver, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380388 |
HDEPO HSA Qualified 320, Silver, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380385 |
HDEPO HSA Qualified 320, Silver, NS, INN, Dep25, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380389 |
HDEPO HSA Qualified 320, Silver, NS, INN, Dep29, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380391 |
HDEPO HSA Qualified 320, Silver, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380390 |
HDEPO HSA Qualified 320, Silver, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380386 |
HDEPO HSA Qualified 320, Silver, NS, INN, Dep29, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380940 |
HDEPO HSA Qualified 326, Silver, NS, INN, Dep25, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380945 |
HDEPO HSA Qualified 326, Silver, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380941 |
HDEPO HSA Qualified 326, Silver, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380938 |
HDEPO HSA Qualified 326, Silver, NS, INN, Dep25, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380942 |
HDEPO HSA Qualified 326, Silver, NS, INN, Dep29, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380944 |
HDEPO HSA Qualified 326, Silver, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380943 |
HDEPO HSA Qualified 326, Silver, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380939 |
HDEPO HSA Qualified 326, Silver, NS, INN, Dep29, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380892 |
HDEPO HSA Qualified 331, Silver, NS, INN, Dep25, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380897 |
HDEPO HSA Qualified 331, Silver, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380893 |
HDEPO HSA Qualified 331, Silver, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380890 |
HDEPO HSA Qualified 331, Silver, NS, INN, Dep25, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380894 |
HDEPO HSA Qualified 331, Silver, NS, INN, Dep29, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380896 |
HDEPO HSA Qualified 331, Silver, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380895 |
HDEPO HSA Qualified 331, Silver, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380891 |
HDEPO HSA Qualified 331, Silver, NS, INN, Dep29, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380435 |
HDEPO HSA Qualified 421, Bronze, NS, INN, Dep25, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380440 |
HDEPO HSA Qualified 421, Bronze, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380436 |
HDEPO HSA Qualified 421, Bronze, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380433 |
HDEPO HSA Qualified 421, Bronze, NS, INN, Dep25, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380437 |
HDEPO HSA Qualified 421, Bronze, NS, INN, Dep29, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380439 |
HDEPO HSA Qualified 421, Bronze, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380438 |
HDEPO HSA Qualified 421, Bronze, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380434 |
HDEPO HSA Qualified 421, Bronze, NS, INN, Dep29, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380844 |
HDEPO HSA Qualified 424, Bronze, NS, INN, Dep25, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380849 |
HDEPO HSA Qualified 424, Bronze, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380845 |
HDEPO HSA Qualified 424, Bronze, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380842 |
HDEPO HSA Qualified 424, Bronze, NS, INN, Dep25, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380846 |
HDEPO HSA Qualified 424, Bronze, NS, INN, Dep29, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380848 |
HDEPO HSA Qualified 424, Bronze, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380847 |
HDEPO HSA Qualified 424, Bronze, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0380843 |
HDEPO HSA Qualified 424, Bronze, NS, INN, Dep29, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0390067 |
PPO Copay/Coinsurance 131, Platinum, NS, INN, Dep25, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0390072 |
PPO Copay/Coinsurance 131, Platinum, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0390068 |
PPO Copay/Coinsurance 131, Platinum, NS, INN, Dep25, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0390065 |
PPO Copay/Coinsurance 131, Platinum, NS, INN, Dep25, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0390069 |
PPO Copay/Coinsurance 131, Platinum, NS, INN, Dep29, Adult Vision, Lasik, Wellness |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0390071 |
PPO Copay/Coinsurance 131, Platinum, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0390070 |
PPO Copay/Coinsurance 131, Platinum, NS, INN, Dep29, Adult Vision, Lasik, Wellness, DP, FP |
2024 |
NYN003
|
Feb 12, 2024 |
| 92551NY0390066 |
PPO Copay/Coinsurance 131, Platinum, NS, INN, Dep29, Adult Vision, Lasik, Wellness, FP |
2024 |
NYN003
|
Feb 12, 2024 |
