| 39520KS0040041 |
Select by Medica Bronze $0 Copay PCP Visits |
2025 |
PREFERREDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040041 |
Select by Medica Bronze $0 Copay PCP Visits |
2025 |
PREFERREDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040041 |
Select by Medica Bronze $0 Copay PCP Visits |
2025 |
PREFERRED [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040041 |
Select by Medica Bronze $0 Copay PCP Visits |
2025 |
PREFERRED [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040041 |
Select by Medica Bronze $0 Copay PCP Visits |
2025 |
STANDARDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040041 |
Select by Medica Bronze $0 Copay PCP Visits |
2025 |
STANDARDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040029 |
Select by Medica Bronze Share |
2025 |
STANDARDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040029 |
Select by Medica Bronze Share |
2025 |
STANDARDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040029 |
Select by Medica Bronze Share |
2025 |
PREFERRED [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040029 |
Select by Medica Bronze Share |
2025 |
PREFERRED [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040029 |
Select by Medica Bronze Share |
2025 |
PREFERREDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040029 |
Select by Medica Bronze Share |
2025 |
PREFERREDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040073 |
Select by Medica Expanded Bronze Standard |
2025 |
STANDARDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040073 |
Select by Medica Expanded Bronze Standard |
2025 |
STANDARDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040073 |
Select by Medica Expanded Bronze Standard |
2025 |
PREFERRED [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040073 |
Select by Medica Expanded Bronze Standard |
2025 |
PREFERRED [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040073 |
Select by Medica Expanded Bronze Standard |
2025 |
PREFERREDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040073 |
Select by Medica Expanded Bronze Standard |
2025 |
PREFERREDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040045 |
Select by Medica Gold $0 Copay PCP Visits |
2025 |
STANDARDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040045 |
Select by Medica Gold $0 Copay PCP Visits |
2025 |
STANDARDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040045 |
Select by Medica Gold $0 Copay PCP Visits |
2025 |
PREFERRED [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040045 |
Select by Medica Gold $0 Copay PCP Visits |
2025 |
PREFERRED [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040045 |
Select by Medica Gold $0 Copay PCP Visits |
2025 |
PREFERREDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040045 |
Select by Medica Gold $0 Copay PCP Visits |
2025 |
PREFERREDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040075 |
Select by Medica Gold Share |
2025 |
STANDARDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040075 |
Select by Medica Gold Share |
2025 |
STANDARDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040075 |
Select by Medica Gold Share |
2025 |
PREFERRED [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040075 |
Select by Medica Gold Share |
2025 |
PREFERRED [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040075 |
Select by Medica Gold Share |
2025 |
PREFERREDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040075 |
Select by Medica Gold Share |
2025 |
PREFERREDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040055 |
Select by Medica Gold Standard |
2025 |
PREFERREDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040055 |
Select by Medica Gold Standard |
2025 |
PREFERREDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040055 |
Select by Medica Gold Standard |
2025 |
PREFERRED [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040055 |
Select by Medica Gold Standard |
2025 |
STANDARDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040055 |
Select by Medica Gold Standard |
2025 |
PREFERRED [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040055 |
Select by Medica Gold Standard |
2025 |
STANDARDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040074 |
Select by Medica Silver $0 Copay PCP Visits |
2025 |
STANDARDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040074 |
Select by Medica Silver $0 Copay PCP Visits |
2025 |
STANDARDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040074 |
Select by Medica Silver $0 Copay PCP Visits |
2025 |
PREFERRED [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040074 |
Select by Medica Silver $0 Copay PCP Visits |
2025 |
PREFERRED [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040074 |
Select by Medica Silver $0 Copay PCP Visits |
2025 |
PREFERREDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040074 |
Select by Medica Silver $0 Copay PCP Visits |
2025 |
PREFERREDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040076 |
Select by Medica Silver Share |
2025 |
STANDARDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040076 |
Select by Medica Silver Share |
2025 |
STANDARDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040076 |
Select by Medica Silver Share |
2025 |
PREFERRED [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040076 |
Select by Medica Silver Share |
2025 |
PREFERRED [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040076 |
Select by Medica Silver Share |
2025 |
PREFERREDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040076 |
Select by Medica Silver Share |
2025 |
PREFERREDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040057 |
Select by Medica Silver Standard |
2025 |
PREFERRED [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040057 |
Select by Medica Silver Standard |
2025 |
STANDARDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040057 |
Select by Medica Silver Standard |
2025 |
STANDARDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040057 |
Select by Medica Silver Standard |
2025 |
PREFERRED [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040057 |
Select by Medica Silver Standard |
2025 |
PREFERREDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0040057 |
Select by Medica Silver Standard |
2025 |
PREFERREDTIER [PCP] [Dentist]
|
Aug 13, 2024 |
| 39520KS0050049 |
Medica Connect Bronze Basic |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050049 |
Medica Connect Bronze Basic |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050049 |
Medica Connect Bronze Basic |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050049 |
Medica Connect Bronze Basic |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050049 |
Medica Connect Bronze Basic |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050049 |
Medica Connect Bronze Basic |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050029 |
Medica Connect Bronze Share Plus |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050029 |
Medica Connect Bronze Share Plus |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050029 |
Medica Connect Bronze Share Plus |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050029 |
Medica Connect Bronze Share Plus |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050029 |
Medica Connect Bronze Share Plus |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050029 |
Medica Connect Bronze Share Plus |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050013 |
Medica Connect Catastrophic |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050013 |
Medica Connect Catastrophic |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050013 |
Medica Connect Catastrophic |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050013 |
Medica Connect Catastrophic |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050013 |
Medica Connect Catastrophic |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050013 |
Medica Connect Catastrophic |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050073 |
Medica Connect Expanded Bronze Standard |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050073 |
Medica Connect Expanded Bronze Standard |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050073 |
Medica Connect Expanded Bronze Standard |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050073 |
Medica Connect Expanded Bronze Standard |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050073 |
Medica Connect Expanded Bronze Standard |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050073 |
Medica Connect Expanded Bronze Standard |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050055 |
Medica Connect Gold Standard |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050055 |
Medica Connect Gold Standard |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050055 |
Medica Connect Gold Standard |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050055 |
Medica Connect Gold Standard |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050055 |
Medica Connect Gold Standard |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050055 |
Medica Connect Gold Standard |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050057 |
Medica Connect Silver Standard |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050057 |
Medica Connect Silver Standard |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050057 |
Medica Connect Silver Standard |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050057 |
Medica Connect Silver Standard |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050057 |
Medica Connect Silver Standard |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0050057 |
Medica Connect Silver Standard |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040041 |
Select by Medica Bronze Copay $0 PCP |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040041 |
Select by Medica Bronze Copay $0 PCP |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040041 |
Select by Medica Bronze Copay $0 PCP |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040041 |
Select by Medica Bronze Copay $0 PCP |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040041 |
Select by Medica Bronze Copay $0 PCP |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040041 |
Select by Medica Bronze Copay $0 PCP |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040051 |
Select by Medica Bronze Premier |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040051 |
Select by Medica Bronze Premier |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040051 |
Select by Medica Bronze Premier |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040051 |
Select by Medica Bronze Premier |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040051 |
Select by Medica Bronze Premier |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040051 |
Select by Medica Bronze Premier |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040029 |
Select by Medica Bronze Share Plus |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040029 |
Select by Medica Bronze Share Plus |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040029 |
Select by Medica Bronze Share Plus |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040029 |
Select by Medica Bronze Share Plus |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040029 |
Select by Medica Bronze Share Plus |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040029 |
Select by Medica Bronze Share Plus |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040059 |
Select by Medica Bronze Standard |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040059 |
Select by Medica Bronze Standard |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040059 |
Select by Medica Bronze Standard |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040059 |
Select by Medica Bronze Standard |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040059 |
Select by Medica Bronze Standard |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040059 |
Select by Medica Bronze Standard |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040073 |
Select by Medica Expanded Bronze Standard |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040073 |
Select by Medica Expanded Bronze Standard |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040073 |
Select by Medica Expanded Bronze Standard |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040073 |
Select by Medica Expanded Bronze Standard |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040073 |
Select by Medica Expanded Bronze Standard |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040073 |
Select by Medica Expanded Bronze Standard |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040045 |
Select by Medica Gold Copay $0 PCP |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040045 |
Select by Medica Gold Copay $0 PCP |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040045 |
Select by Medica Gold Copay $0 PCP |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040045 |
Select by Medica Gold Copay $0 PCP |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040045 |
Select by Medica Gold Copay $0 PCP |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040045 |
Select by Medica Gold Copay $0 PCP |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040055 |
Select by Medica Gold Standard |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040055 |
Select by Medica Gold Standard |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040055 |
Select by Medica Gold Standard |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040055 |
Select by Medica Gold Standard |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040055 |
Select by Medica Gold Standard |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040055 |
Select by Medica Gold Standard |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040057 |
Select by Medica Silver Standard |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040057 |
Select by Medica Silver Standard |
2024 |
STANDARDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040057 |
Select by Medica Silver Standard |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040057 |
Select by Medica Silver Standard |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040057 |
Select by Medica Silver Standard |
2024 |
PREFERRED [PCP] [Dentist]
|
Nov 17, 2023 |
| 39520KS0040057 |
Select by Medica Silver Standard |
2024 |
PREFERREDTIER [PCP] [Dentist]
|
Nov 17, 2023 |
