RITE AID PHARMACY 05817
Accepted Insurance Health Plans for NPI 1467561985
Pharmacy - Community/Retail Pharmacy in Bakersfield, CA

NPI Status: Active since August 29, 2006

Contact Information

8000 WHITE LANE
BAKERSFIELD, CA
ZIP 93309
Phone: (661) 837-2198

Table of Contents - List of Insurance Companies

Aetna CVS Health
BannerAetna
Blue Cross and Blue Shield of Alabama
Blue Cross and Blue Shield of Illinois
Blue Cross and Blue Shield of Texas
Blue Cross Blue Shield of North Dakota
Blue Cross Blue Shield of Wyoming
Medica
Moda Health Plan, Inc.

Accepted Health Plans and Insurance Coverage

List of insurance companies accepted by RITE AID PHARMACY 05817. Use our filterable tables to quickly find the details of your health plan, including: Plan Name, Plan Type and Plan ID. Search this page to find if your specific insurance is accepted. Please verify directly with the provider to make sure your healthplan is currently accepted.

Aetna CVS Health

Plan Name	Plan Type	Plan ID	Dental Only Plan?
Bronze 1 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay	HMO	99129IL0120001	No
Bronze 2 Advanced HSA: Aetna network + CVS Health Virtual Primary Care	EPO	48161MO0200003	No
Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care	EPO	84600KS0130001	No
Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care	HMO	61671NC0100001	No
Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care	HMO	84867OH0100001	No
Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care	HMO	96992IN0060001	No
Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7	HMO	18628FL0160054	No
Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7	HMO	96992IN0060002	No
Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	EPO	84600KS0130002	No
Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	61671NC0100016	No
Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	84867OH0100002	No
Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	99129IL0120012	No
Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision	EPO	84600KS0130010	No
Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision	HMO	18628FL0160060	No
Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision	HMO	61671NC0100022	No
Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision	HMO	84867OH0100010	No
Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision	HMO	96992IN0060010	No
Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision	HMO	99129IL0120032	No
Bronze 4 Advanced: Aetna network + $0 CVS Health Virtual Primary Care	EPO	48161MO0200028	No
Bronze 4 Advanced: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental + Vision	EPO	48161MO0200040	No
Bronze S: Aetna network + $0 CVS Health Virtual Primary Care	EPO	48161MO0200016	No
Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7	HMO	18628FL0160022	No
Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7	HMO	96992IN0060003	No
Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	EPO	84600KS0130003	No
Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	61671NC0100006	No
Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	84867OH0100003	No
Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	99129IL0120003	No
Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7	HMO	18628FL0160061	No
Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7	HMO	96992IN0060011	No
Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	EPO	84600KS0130011	No
Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	61671NC0100023	No
Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	84867OH0100011	No
Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	99129IL0120033	No
Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision	EPO	84600KS0130012	No
Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision	HMO	18628FL0160062	No
Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision	HMO	61671NC0100024	No
Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision	HMO	84867OH0100012	No
Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision	HMO	96992IN0060012	No
Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision	HMO	99129IL0120034	No
Gold 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision	HMO	58840TX0110147	No
Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7	HMO	18628FL0160055	No
Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7	HMO	96992IN0060004	No
Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	EPO	84600KS0130004	No
Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	61671NC0100017	No
Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	84867OH0100004	No
Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay	HMO	99129IL0120017	No
Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision	EPO	84600KS0130013	No
Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision	HMO	18628FL0160063	No
Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision	HMO	61671NC0100025	No
Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision	HMO	96992IN0060013	No
Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision + Rx Copay	HMO	99129IL0120035	No
Gold 3 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7	HMO	58840TX0110075	No
Gold 3 Advanced: Aetna network + $0 walk-in clinic + Adult Dental + Vision	HMO	58840TX0110149	No
Gold 4 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7	HMO	58840TX0110085	No
Gold S: Aetna network + $0 CVS Health Virtual Primary Care	EPO	48161MO0200019	No
Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7	HMO	18628FL0160030	No
Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7	HMO	96992IN0060005	No
Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	EPO	84600KS0130005	No
Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	61671NC0100007	No
Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	67190DE0100008	No
Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	84867OH0100005	No
Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay	HMO	99129IL0120005	No
Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay	PPO	72547IL0170005	No
Gold S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7	HMO	58840TX0110033	No
Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7	HMO	18628FL0160064	No
Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7	HMO	96992IN0060014	No
Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	EPO	84600KS0130014	No
Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	61671NC0100026	No
Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	84867OH0100013	No
Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	99129IL0120036	No
Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision	EPO	84600KS0130015	No
Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision	HMO	18628FL0160065	No
Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision	HMO	61671NC0100027	No
Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision	HMO	84867OH0100014	No
Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision	HMO	96992IN0060015	No
Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision	HMO	99129IL0120037	No
Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7	HMO	58840TX0110151	No
Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision	HMO	58840TX0110152	No
Silver 10 Advanced: Aetna network + $0 CVS Health Virtual Primary Care	EPO	48161MO0200044	No
Silver 10 Advanced: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental + Vision	EPO	48161MO0200045	No
Silver 5 Advanced: Aetna network + $0 CVS Health Virtual Primary Care	EPO	48161MO0200015	No
Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7	HMO	18628FL0160029	No
Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7	HMO	96992IN0060006	No
Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	EPO	84600KS0130006	No
Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	61671NC0100019	No
Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	84867OH0100006	No
Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay	HMO	99129IL0120006	No
Silver 5 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision + Rx Copay	HMO	99129IL0120038	No
Silver 5 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7	HMO	58840TX0110103	No
Silver S: Aetna network + $0 CVS Health Virtual Primary Care	EPO	48161MO0200025	No
Silver S: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental+Vision	EPO	48161MO0200046	No
Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7	HMO	18628FL0160009	No
Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7	HMO	96992IN0060009	No
Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision	HMO	18628FL0160067	No
Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision	HMO	96992IN0060016	No
Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	EPO	84600KS0130009	No
Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	61671NC0100009	No
Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	67190DE0100009	No
Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	84867OH0100009	No
Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	HMO	99129IL0120009	No
Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care	PPO	72547IL0170009	No
Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Adult Dental+Vision	EPO	84600KS0130016	No
Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Adult Dental+Vision	HMO	61671NC0100028	No
Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Adult Dental+Vision	HMO	84867OH0100015	No
Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7	HMO	58840TX0110055	No
Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision	HMO	58840TX0110154	No

BannerAetna

Plan Name	Plan Type	Plan ID	Dental Only Plan?
BannerAetna Bronze 2 HSA: No PCP required + 98point6 virtual care 24/7	HMO	23435AZ0040001	No
BannerAetna Bronze 4: No PCP required + $0 PCP + free 98.6 virtual care 24/7 + Adult Dental + Vision	HMO	23435AZ0040022	No
BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7	HMO	23435AZ0040016	No
BannerAetna Bronze S: No PCP required + free 98point6 virtual care 24/7	HMO	23435AZ0040011	No
BannerAetna Gold 10: No PCP required + $0 PCP + free 98.6 virtual care 24/7 + Adult Dental + Vision	HMO	23435AZ0040023	No
BannerAetna Gold 10: No PCP required + $0 PCP + free 98point6 virtual care 24/7	HMO	23435AZ0040028	No
BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7	HMO	23435AZ0040017	No
BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision	HMO	23435AZ0040024	No
BannerAetna Gold S: No PCP required + free 98point6 virtual care 24/7	HMO	23435AZ0040012	No
BannerAetna Silver 10: No PCP required + $0 PCP + free 98.6 virtual care 24/7 + Adult Dental +Vision	HMO	23435AZ0040025	No
BannerAetna Silver 4: No PCP required + free 98point6 virtual care 24/7	HMO	23435AZ0040014	No
BannerAetna Silver 4: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision	HMO	23435AZ0040026	No
BannerAetna Silver 5: No PCP required + free 98point6 virtual care 24/7	HMO	23435AZ0040019	No
BannerAetna Silver S: No PCP required + free 98point6 virtual care 24/7	HMO	23435AZ0040015	No
BannerAetna Silver S: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision	HMO	23435AZ0040027	No

Blue Cross and Blue Shield of Alabama

Plan Name	Plan Type	Plan ID	Dental Only Plan?
Blue Cross Select Gold	PPO	46944AL0650001	No
Blue Cross Select Silver	PPO	46944AL0660001	No
Blue HSA Bronze	PPO	46944AL0560001	No
Blue Protect	PPO	46944AL0470001	No
Blue Saver Bronze	PPO	46944AL0460001	No
Blue Saver Silver EPO	EPO	46944AL0710001	No
Blue Standardized Bronze	PPO	46944AL0750001	No
Blue Standardized Gold	PPO	46944AL0720001	No
Blue Standardized Silver	PPO	46944AL0730001	No
Blue Standardized Silver EPO	EPO	46944AL0740001	No
Blue Value Gold	PPO	46944AL0370001	No
Blue Value Silver	PPO	46944AL0410001	No
Blue Access Gold for Business	PPO	46944AL0340001	No
Blue Choice Platinum for Business	PPO	46944AL0280001	No
Blue HSA Silver for Business	PPO	46944AL0680001	No
Blue Saver Bronze for Business	PPO	46944AL0430001	No
Blue Saver Gold for Business	PPO	46944AL0760001	No
Blue Secure Gold for Business	PPO	46944AL0670001	No
Blue Secure Silver for Business	PPO	46944AL0380001	No

Blue Cross and Blue Shield of Illinois

Plan Name	Plan Type	Plan ID	Dental Only Plan?
Blue Choice Preferred Bronze PPO? 201	PPO	36096IL0990127	No
Blue Choice Preferred Bronze PPO? 201	PPO	36096IL0990188	No
Blue Choice Preferred Bronze PPO? 201	PPO	36096IL0990189	No
Blue Choice Preferred Bronze PPO? 201	PPO	36096IL0990190	No
Blue Choice Preferred Bronze PPO? 201	PPO	36096IL0990191	No
Blue Choice Preferred Bronze PPO? 201	PPO	36096IL0990192	No
Blue Choice Preferred Bronze PPO? 201	PPO	36096IL0990193	No
Blue Choice Preferred Bronze PPO? 201	PPO	36096IL0990194	No
Blue Choice Preferred Bronze PPO? 201	PPO	36096IL0990195	No
Blue Choice Preferred Bronze PPO? 201	PPO	36096IL0990196	No
Blue Choice Preferred Bronze PPO? 201	PPO	36096IL0990197	No
Blue Choice Preferred Bronze PPO? 201	PPO	36096IL0990198	No
Blue Choice Preferred Bronze PPO? 201	PPO	36096IL0990199	No
Blue Choice Preferred Bronze PPO? 701	PPO	36096IL0990265	No
Blue Choice Preferred Bronze PPO? 701	PPO	36096IL0990267	No
Blue Choice Preferred Bronze PPO? 701	PPO	36096IL0990268	No
Blue Choice Preferred Bronze PPO? 701	PPO	36096IL0990269	No
Blue Choice Preferred Bronze PPO? 701	PPO	36096IL0990270	No
Blue Choice Preferred Bronze PPO? 701	PPO	36096IL0990271	No
Blue Choice Preferred Bronze PPO? 701	PPO	36096IL0990272	No
Blue Choice Preferred Bronze PPO? 701	PPO	36096IL0990273	No
Blue Choice Preferred Bronze PPO? 701	PPO	36096IL0990274	No
Blue Choice Preferred Bronze PPO? 701	PPO	36096IL0990275	No
Blue Choice Preferred Bronze PPO? 701	PPO	36096IL0990276	No
Blue Choice Preferred Bronze PPO? 701	PPO	36096IL0990277	No
Blue Choice Preferred Bronze PPO? 701	PPO	36096IL0990278	No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays	PPO	36096IL0990306	No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays	PPO	36096IL0990332	No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays	PPO	36096IL0990333	No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays	PPO	36096IL0990334	No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays	PPO	36096IL0990335	No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays	PPO	36096IL0990336	No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays	PPO	36096IL0990337	No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays	PPO	36096IL0990338	No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays	PPO	36096IL0990339	No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays	PPO	36096IL0990340	No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays	PPO	36096IL0990341	No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays	PPO	36096IL0990342	No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays	PPO	36096IL0990343	No
Blue Choice Preferred Gold PPO? 204	PPO	36096IL0990122	No
Blue Choice Preferred Gold PPO? 204	PPO	36096IL0990128	No
Blue Choice Preferred Gold PPO? 204	PPO	36096IL0990129	No
Blue Choice Preferred Gold PPO? 204	PPO	36096IL0990130	No
Blue Choice Preferred Gold PPO? 204	PPO	36096IL0990131	No
Blue Choice Preferred Gold PPO? 204	PPO	36096IL0990132	No
Blue Choice Preferred Gold PPO? 204	PPO	36096IL0990133	No
Blue Choice Preferred Gold PPO? 204	PPO	36096IL0990134	No
Blue Choice Preferred Gold PPO? 204	PPO	36096IL0990135	No
Blue Choice Preferred Gold PPO? 204	PPO	36096IL0990136	No
Blue Choice Preferred Gold PPO? 204	PPO	36096IL0990137	No
Blue Choice Preferred Gold PPO? 204	PPO	36096IL0990138	No
Blue Choice Preferred Gold PPO? 204	PPO	36096IL0990139	No
Blue Choice Preferred Gold PPO? Standard - Rx Copays	PPO	36096IL0990279	No
Blue Choice Preferred Gold PPO? Standard - Rx Copays	PPO	36096IL0990282	No
Blue Choice Preferred Gold PPO? Standard - Rx Copays	PPO	36096IL0990283	No
Blue Choice Preferred Gold PPO? Standard - Rx Copays	PPO	36096IL0990284	No
Blue Choice Preferred Gold PPO? Standard - Rx Copays	PPO	36096IL0990285	No
Blue Choice Preferred Gold PPO? Standard - Rx Copays	PPO	36096IL0990286	No
Blue Choice Preferred Gold PPO? Standard - Rx Copays	PPO	36096IL0990287	No
Blue Choice Preferred Gold PPO? Standard - Rx Copays	PPO	36096IL0990288	No
Blue Choice Preferred Gold PPO? Standard - Rx Copays	PPO	36096IL0990289	No
Blue Choice Preferred Gold PPO? Standard - Rx Copays	PPO	36096IL0990290	No
Blue Choice Preferred Gold PPO? Standard - Rx Copays	PPO	36096IL0990291	No
Blue Choice Preferred Gold PPO? Standard - Rx Copays	PPO	36096IL0990292	No
Blue Choice Preferred Gold PPO? Standard - Rx Copays	PPO	36096IL0990293	No
Blue Choice Preferred Security PPO? 200	PPO	36096IL0990126	No
Blue Choice Preferred Security PPO? 200	PPO	36096IL0990176	No
Blue Choice Preferred Security PPO? 200	PPO	36096IL0990177	No
Blue Choice Preferred Security PPO? 200	PPO	36096IL0990178	No
Blue Choice Preferred Security PPO? 200	PPO	36096IL0990179	No
Blue Choice Preferred Security PPO? 200	PPO	36096IL0990180	No
Blue Choice Preferred Security PPO? 200	PPO	36096IL0990181	No
Blue Choice Preferred Security PPO? 200	PPO	36096IL0990182	No
Blue Choice Preferred Security PPO? 200	PPO	36096IL0990183	No
Blue Choice Preferred Security PPO? 200	PPO	36096IL0990184	No
Blue Choice Preferred Security PPO? 200	PPO	36096IL0990185	No
Blue Choice Preferred Security PPO? 200	PPO	36096IL0990186	No
Blue Choice Preferred Security PPO? 200	PPO	36096IL0990187	No
Blue Choice Preferred Silver PPO? 203	PPO	36096IL0990123	No
Blue Choice Preferred Silver PPO? 203	PPO	36096IL0990140	No
Blue Choice Preferred Silver PPO? 203	PPO	36096IL0990141	No
Blue Choice Preferred Silver PPO? 203	PPO	36096IL0990142	No
Blue Choice Preferred Silver PPO? 203	PPO	36096IL0990143	No
Blue Choice Preferred Silver PPO? 203	PPO	36096IL0990144	No
Blue Choice Preferred Silver PPO? 203	PPO	36096IL0990145	No
Blue Choice Preferred Silver PPO? 203	PPO	36096IL0990146	No
Blue Choice Preferred Silver PPO? 203	PPO	36096IL0990147	No
Blue Choice Preferred Silver PPO? 203	PPO	36096IL0990148	No
Blue Choice Preferred Silver PPO? 203	PPO	36096IL0990149	No
Blue Choice Preferred Silver PPO? 203	PPO	36096IL0990150	No
Blue Choice Preferred Silver PPO? 203	PPO	36096IL0990151	No
Blue Choice Preferred Silver PPO? 801	PPO	36096IL0990361	No
Blue Choice Preferred Silver PPO? 801	PPO	36096IL0990362	No
Blue Choice Preferred Silver PPO? 801	PPO	36096IL0990363	No
Blue Choice Preferred Silver PPO? 801	PPO	36096IL0990364	No
Blue Choice Preferred Silver PPO? 801	PPO	36096IL0990365	No
Blue Choice Preferred Silver PPO? 801	PPO	36096IL0990366	No
Blue Choice Preferred Silver PPO? 801	PPO	36096IL0990367	No
Blue Choice Preferred Silver PPO? 801	PPO	36096IL0990368	No
Blue Choice Preferred Silver PPO? 801	PPO	36096IL0990369	No
Blue Choice Preferred Silver PPO? 801	PPO	36096IL0990370	No
Blue Choice Preferred Silver PPO? 801	PPO	36096IL0990371	No
Blue Choice Preferred Silver PPO? 801	PPO	36096IL0990372	No
Blue Choice Preferred Silver PPO? 801	PPO	36096IL0990373	No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays	PPO	36096IL0990280	No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays	PPO	36096IL0990294	No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays	PPO	36096IL0990295	No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays	PPO	36096IL0990296	No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays	PPO	36096IL0990297	No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays	PPO	36096IL0990298	No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays	PPO	36096IL0990299	No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays	PPO	36096IL0990300	No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays	PPO	36096IL0990344	No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays	PPO	36096IL0990345	No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays	PPO	36096IL0990346	No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays	PPO	36096IL0990347	No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays	PPO	36096IL0990348	No

Blue Cross and Blue Shield of Texas

Plan Name	Plan Type	Plan ID	Dental Only Plan?
Blue Advantage Bronze HMO? 204	HMO	33602TX0460554	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460705	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460706	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460707	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460708	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460709	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460710	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460711	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460712	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460713	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460714	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460715	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460716	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460717	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460718	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460719	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460721	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460722	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460723	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460724	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460725	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460726	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460727	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460728	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0460869	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0461073	No
Blue Advantage Bronze HMO? 204	HMO	33602TX0461074	No
Blue Advantage Bronze HMO? 301	HMO	33602TX0460782	No
Blue Advantage Bronze HMO? 301	HMO	33602TX0460783	No
Blue Advantage Bronze HMO? 301	HMO	33602TX0460787	No
Blue Advantage Bronze HMO? 301	HMO	33602TX0460792	No
Blue Advantage Bronze HMO? 301	HMO	33602TX0460793	No
Blue Advantage Bronze HMO? 301	HMO	33602TX0460794	No
Blue Advantage Bronze HMO? 301	HMO	33602TX0460795	No
Blue Advantage Bronze HMO? 301	HMO	33602TX0460797	No
Blue Advantage Bronze HMO? 301	HMO	33602TX0460799	No
Blue Advantage Bronze HMO? 301	HMO	33602TX0460801	No
Blue Advantage Bronze HMO? 301	HMO	33602TX0460802	No
Blue Advantage Bronze HMO? 301	HMO	33602TX0460803	No
Blue Advantage Bronze HMO? 301	HMO	33602TX0460804	No
Blue Advantage Bronze HMO? 301	HMO	33602TX0460806	No
Blue Advantage Bronze HMO? 301	HMO	33602TX0460871	No
Blue Advantage Bronze HMO? 301	HMO	33602TX0461076	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461033	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461034	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461035	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461036	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461037	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461038	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461039	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461040	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461041	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461042	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461043	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461044	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461045	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461046	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461047	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461048	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461049	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461050	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461051	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461052	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461053	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461054	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461055	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461056	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461057	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461058	No
Blue Advantage Bronze HMO? Standard	HMO	33602TX0461079	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460548	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460555	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460556	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460557	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460558	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460559	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460560	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460561	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460562	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460563	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460564	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460565	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460566	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460567	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460568	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460569	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460571	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460572	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460573	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460574	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460575	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460576	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460577	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460578	No
Blue Advantage Gold HMO? 206	HMO	33602TX0460863	No
Blue Advantage Gold HMO? 206	HMO	33602TX0461061	No
Blue Advantage Gold HMO? 206	HMO	33602TX0461062	No
Blue Advantage Gold HMO? 603	HMO	33602TX0460809	No
Blue Advantage Gold HMO? 603	HMO	33602TX0460814	No
Blue Advantage Gold HMO? 603	HMO	33602TX0460819	No
Blue Advantage Gold HMO? 603	HMO	33602TX0460820	No
Blue Advantage Gold HMO? 603	HMO	33602TX0460821	No
Blue Advantage Gold HMO? 603	HMO	33602TX0460822	No
Blue Advantage Gold HMO? 603	HMO	33602TX0460824	No
Blue Advantage Gold HMO? 603	HMO	33602TX0460826	No
Blue Advantage Gold HMO? 603	HMO	33602TX0460828	No
Blue Advantage Gold HMO? 603	HMO	33602TX0460829	No
Blue Advantage Gold HMO? 603	HMO	33602TX0460830	No
Blue Advantage Gold HMO? 603	HMO	33602TX0460831	No
Blue Advantage Gold HMO? 603	HMO	33602TX0460833	No
Blue Advantage Gold HMO? 603	HMO	33602TX0460860	No
Blue Advantage Gold HMO? 603	HMO	33602TX0460865	No
Blue Advantage Gold HMO? 603	HMO	33602TX0461066	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460925	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460928	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460929	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460930	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460931	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460932	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460933	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460934	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460935	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460936	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460937	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460938	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460939	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460940	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460941	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460942	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460943	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460944	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460945	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460946	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460947	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460948	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460949	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460950	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460951	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460952	No
Blue Advantage Gold HMO? Standard	HMO	33602TX0460953	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870002	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870038	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870039	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870040	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870041	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870042	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870043	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870044	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870045	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870046	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870047	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870048	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870049	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870050	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870051	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870052	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870053	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870054	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870055	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870056	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870057	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870058	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870059	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870060	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870061	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870062	No
Blue Advantage Plus Bronze? 303	POS	33602TX0870063	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870003	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870064	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870065	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870066	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870067	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870068	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870069	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870070	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870071	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870072	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870073	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870074	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870075	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870076	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870077	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870078	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870079	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870080	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870081	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870082	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870083	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870084	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870085	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870086	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870087	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870088	No
Blue Advantage Plus Bronze? 305	POS	33602TX0870089	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870004	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870090	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870091	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870092	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870093	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870094	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870095	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870096	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870097	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870098	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870099	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870100	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870101	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870102	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870103	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870104	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870105	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870106	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870107	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870108	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870109	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870110	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870111	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870112	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870113	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870114	No
Blue Advantage Plus Bronze? Standard	POS	33602TX0870115	No
Blue Advantage Plus Gold? 203	POS	33602TX0870005	No
Blue Advantage Plus Gold? 203	POS	33602TX0870116	No
Blue Advantage Plus Gold? 203	POS	33602TX0870117	No
Blue Advantage Plus Gold? 203	POS	33602TX0870118	No
Blue Advantage Plus Gold? 203	POS	33602TX0870119	No
Blue Advantage Plus Gold? 203	POS	33602TX0870120	No
Blue Advantage Plus Gold? 203	POS	33602TX0870121	No
Blue Advantage Plus Gold? 203	POS	33602TX0870122	No
Blue Advantage Plus Gold? 203	POS	33602TX0870123	No
Blue Advantage Plus Gold? 203	POS	33602TX0870124	No
Blue Advantage Plus Gold? 203	POS	33602TX0870125	No
Blue Advantage Plus Gold? 203	POS	33602TX0870126	No
Blue Advantage Plus Gold? 203	POS	33602TX0870127	No
Blue Advantage Plus Gold? 203	POS	33602TX0870128	No
Blue Advantage Plus Gold? 203	POS	33602TX0870129	No
Blue Advantage Plus Gold? 203	POS	33602TX0870130	No
Blue Advantage Plus Gold? 203	POS	33602TX0870131	No
Blue Advantage Plus Gold? 203	POS	33602TX0870132	No
Blue Advantage Plus Gold? 203	POS	33602TX0870133	No
Blue Advantage Plus Gold? 203	POS	33602TX0870134	No
Blue Advantage Plus Gold? 203	POS	33602TX0870135	No
Blue Advantage Plus Gold? 203	POS	33602TX0870136	No
Blue Advantage Plus Gold? 203	POS	33602TX0870137	No
Blue Advantage Plus Gold? 203	POS	33602TX0870138	No
Blue Advantage Plus Gold? 203	POS	33602TX0870139	No
Blue Advantage Plus Gold? 203	POS	33602TX0870140	No
Blue Advantage Plus Gold? 203	POS	33602TX0870141	No
Blue Advantage Plus Gold? 803	POS	33602TX0870011	No
Blue Advantage Plus Gold? 803	POS	33602TX0870272	No
Blue Advantage Plus Gold? 803	POS	33602TX0870273	No
Blue Advantage Plus Gold? 803	POS	33602TX0870274	No
Blue Advantage Plus Gold? 803	POS	33602TX0870275	No
Blue Advantage Plus Gold? 803	POS	33602TX0870276	No
Blue Advantage Plus Gold? 803	POS	33602TX0870277	No
Blue Advantage Plus Gold? 803	POS	33602TX0870278	No
Blue Advantage Plus Gold? 803	POS	33602TX0870279	No
Blue Advantage Plus Gold? 803	POS	33602TX0870280	No
Blue Advantage Plus Gold? 803	POS	33602TX0870281	No
Blue Advantage Plus Gold? 803	POS	33602TX0870282	No
Blue Advantage Plus Gold? 803	POS	33602TX0870283	No
Blue Advantage Plus Gold? 803	POS	33602TX0870284	No
Blue Advantage Plus Gold? 803	POS	33602TX0870285	No
Blue Advantage Plus Gold? 803	POS	33602TX0870286	No
Blue Advantage Plus Gold? 803	POS	33602TX0870287	No
Blue Advantage Plus Gold? 803	POS	33602TX0870288	No
Blue Advantage Plus Gold? 803	POS	33602TX0870289	No
Blue Advantage Plus Gold? 803	POS	33602TX0870290	No
Blue Advantage Plus Gold? 803	POS	33602TX0870291	No
Blue Advantage Plus Gold? 803	POS	33602TX0870292	No
Blue Advantage Plus Gold? 803	POS	33602TX0870293	No
Blue Advantage Plus Gold? 803	POS	33602TX0870294	No
Blue Advantage Plus Gold? 803	POS	33602TX0870295	No
Blue Advantage Plus Gold? 803	POS	33602TX0870296	No
Blue Advantage Plus Gold? 803	POS	33602TX0870297	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870006	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870142	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870143	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870144	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870145	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870146	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870147	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870148	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870149	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870150	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870151	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870152	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870153	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870154	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870155	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870156	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870157	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870158	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870159	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870160	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870161	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870162	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870163	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870164	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870165	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870166	No
Blue Advantage Plus Gold? Standard	POS	33602TX0870167	No
Blue Advantage Plus Silver? 202	POS	33602TX0870007	No
Blue Advantage Plus Silver? 202	POS	33602TX0870168	No
Blue Advantage Plus Silver? 202	POS	33602TX0870169	No
Blue Advantage Plus Silver? 202	POS	33602TX0870170	No
Blue Advantage Plus Silver? 202	POS	33602TX0870171	No
Blue Advantage Plus Silver? 202	POS	33602TX0870172	No
Blue Advantage Plus Silver? 202	POS	33602TX0870173	No
Blue Advantage Plus Silver? 202	POS	33602TX0870174	No
Blue Advantage Plus Silver? 202	POS	33602TX0870175	No
Blue Advantage Plus Silver? 202	POS	33602TX0870176	No
Blue Advantage Plus Silver? 202	POS	33602TX0870177	No
Blue Advantage Plus Silver? 202	POS	33602TX0870178	No
Blue Advantage Plus Silver? 202	POS	33602TX0870179	No
Blue Advantage Plus Silver? 202	POS	33602TX0870180	No
Blue Advantage Plus Silver? 202	POS	33602TX0870181	No
Blue Advantage Plus Silver? 202	POS	33602TX0870182	No
Blue Advantage Plus Silver? 202	POS	33602TX0870183	No
Blue Advantage Plus Silver? 202	POS	33602TX0870184	No
Blue Advantage Plus Silver? 202	POS	33602TX0870185	No
Blue Advantage Plus Silver? 202	POS	33602TX0870186	No
Blue Advantage Plus Silver? 202	POS	33602TX0870187	No
Blue Advantage Plus Silver? 202	POS	33602TX0870188	No
Blue Advantage Plus Silver? 202	POS	33602TX0870189	No
Blue Advantage Plus Silver? 202	POS	33602TX0870190	No
Blue Advantage Plus Silver? 202	POS	33602TX0870191	No
Blue Advantage Plus Silver? 202	POS	33602TX0870192	No
Blue Advantage Plus Silver? 202	POS	33602TX0870193	No
Blue Advantage Plus Silver? 605	POS	33602TX0870009	No
Blue Advantage Plus Silver? 605	POS	33602TX0870220	No
Blue Advantage Plus Silver? 605	POS	33602TX0870221	No
Blue Advantage Plus Silver? 605	POS	33602TX0870222	No
Blue Advantage Plus Silver? 605	POS	33602TX0870223	No
Blue Advantage Plus Silver? 605	POS	33602TX0870224	No
Blue Advantage Plus Silver? 605	POS	33602TX0870225	No
Blue Advantage Plus Silver? 605	POS	33602TX0870226	No
Blue Advantage Plus Silver? 605	POS	33602TX0870227	No
Blue Advantage Plus Silver? 605	POS	33602TX0870228	No
Blue Advantage Plus Silver? 605	POS	33602TX0870229	No
Blue Advantage Plus Silver? 605	POS	33602TX0870230	No
Blue Advantage Plus Silver? 605	POS	33602TX0870231	No
Blue Advantage Plus Silver? 605	POS	33602TX0870232	No
Blue Advantage Plus Silver? 605	POS	33602TX0870233	No
Blue Advantage Plus Silver? 605	POS	33602TX0870234	No
Blue Advantage Plus Silver? 605	POS	33602TX0870235	No
Blue Advantage Plus Silver? 605	POS	33602TX0870236	No
Blue Advantage Plus Silver? 605	POS	33602TX0870237	No
Blue Advantage Plus Silver? 605	POS	33602TX0870238	No
Blue Advantage Plus Silver? 605	POS	33602TX0870239	No
Blue Advantage Plus Silver? 605	POS	33602TX0870240	No
Blue Advantage Plus Silver? 605	POS	33602TX0870241	No
Blue Advantage Plus Silver? 605	POS	33602TX0870242	No
Blue Advantage Plus Silver? 605	POS	33602TX0870243	No
Blue Advantage Plus Silver? 605	POS	33602TX0870244	No
Blue Advantage Plus Silver? 605	POS	33602TX0870245	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870010	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870246	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870247	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870248	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870249	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870250	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870251	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870252	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870253	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870254	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870255	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870256	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870257	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870258	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870259	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870260	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870261	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870262	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870263	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870264	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870265	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870266	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870267	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870268	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870269	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870270	No
Blue Advantage Plus Silver? Standard	POS	33602TX0870271	No
Blue Advantage Security HMO? 200	HMO	33602TX0460552	No
Blue Advantage Security HMO? 200	HMO	33602TX0460655	No
Blue Advantage Security HMO? 200	HMO	33602TX0460656	No
Blue Advantage Security HMO? 200	HMO	33602TX0460657	No
Blue Advantage Security HMO? 200	HMO	33602TX0460658	No
Blue Advantage Security HMO? 200	HMO	33602TX0460659	No
Blue Advantage Security HMO? 200	HMO	33602TX0460660	No
Blue Advantage Security HMO? 200	HMO	33602TX0460661	No
Blue Advantage Security HMO? 200	HMO	33602TX0460662	No
Blue Advantage Security HMO? 200	HMO	33602TX0460663	No
Blue Advantage Security HMO? 200	HMO	33602TX0460664	No
Blue Advantage Security HMO? 200	HMO	33602TX0460665	No
Blue Advantage Security HMO? 200	HMO	33602TX0460666	No
Blue Advantage Security HMO? 200	HMO	33602TX0460667	No
Blue Advantage Security HMO? 200	HMO	33602TX0460668	No
Blue Advantage Security HMO? 200	HMO	33602TX0460669	No
Blue Advantage Security HMO? 200	HMO	33602TX0460671	No
Blue Advantage Security HMO? 200	HMO	33602TX0460672	No
Blue Advantage Security HMO? 200	HMO	33602TX0460673	No
Blue Advantage Security HMO? 200	HMO	33602TX0460674	No
Blue Advantage Security HMO? 200	HMO	33602TX0460675	No
Blue Advantage Security HMO? 200	HMO	33602TX0460676	No
Blue Advantage Security HMO? 200	HMO	33602TX0460677	No
Blue Advantage Security HMO? 200	HMO	33602TX0460678	No
Blue Advantage Security HMO? 200	HMO	33602TX0460872	No
Blue Advantage Security HMO? 200	HMO	33602TX0461077	No
Blue Advantage Security HMO? 200	HMO	33602TX0461078	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460553	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460680	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460681	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460682	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460683	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460684	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460685	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460686	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460687	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460688	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460689	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460690	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460691	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460692	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460693	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460694	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460696	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460697	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460698	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460699	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460700	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460701	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460702	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460703	No
Blue Advantage Silver HMO? 205	HMO	33602TX0460867	No
Blue Advantage Silver HMO? 205	HMO	33602TX0461069	No
Blue Advantage Silver HMO? 205	HMO	33602TX0461070	No
Blue Advantage Silver HMO? 801	HMO	33602TX0461083	No
Blue Advantage Silver HMO? 801	HMO	33602TX0461090	No
Blue Advantage Silver HMO? 801	HMO	33602TX0461094	No
Blue Advantage Silver HMO? 801	HMO	33602TX0461099	No
Blue Advantage Silver HMO? 801	HMO	33602TX0461100	No
Blue Advantage Silver HMO? 801	HMO	33602TX0461101	No
Blue Advantage Silver HMO? 801	HMO	33602TX0461102	No
Blue Advantage Silver HMO? 801	HMO	33602TX0461104	No
Blue Advantage Silver HMO? 801	HMO	33602TX0461105	No
Blue Advantage Silver HMO? 801	HMO	33602TX0461107	No
Blue Advantage Silver HMO? 801	HMO	33602TX0461108	No
Blue Advantage Silver HMO? 801	HMO	33602TX0461109	No
Blue Advantage Silver HMO? 801	HMO	33602TX0461110	No
Blue Advantage Silver HMO? 801	HMO	33602TX0461112	No
Blue Advantage Silver HMO? 801	HMO	33602TX0461114	No
Blue Advantage Silver HMO? 801	HMO	33602TX0461115	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460926	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460954	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460955	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460956	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460957	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460958	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460959	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460960	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460961	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460962	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460963	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460964	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460965	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460966	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460967	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460968	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460969	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460970	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460971	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460972	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460973	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460974	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460975	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460976	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460977	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460978	No
Blue Advantage Silver HMO? Standard	HMO	33602TX0460979	No
MyBlue Health Bronze? 402	HMO	33602TX0461080	No
MyBlue Health Bronze? 402	HMO	33602TX0461116	No
MyBlue Health Bronze? 402	HMO	33602TX0461117	No
MyBlue Health Bronze? 402	HMO	33602TX0461118	No
MyBlue Health Bronze? 402	HMO	33602TX0461119	No
MyBlue Health Bronze? 402	HMO	33602TX0461120	No
MyBlue Health Bronze? 402	HMO	33602TX0461121	No
MyBlue Health Bronze? 402	HMO	33602TX0461122	No
MyBlue Health Bronze? 402	HMO	33602TX0461179	No
MyBlue Health Bronze? Standard	HMO	33602TX0461087	No
MyBlue Health Bronze? Standard	HMO	33602TX0461159	No
MyBlue Health Bronze? Standard	HMO	33602TX0461160	No
MyBlue Health Bronze? Standard	HMO	33602TX0461161	No
MyBlue Health Bronze? Standard	HMO	33602TX0461163	No
MyBlue Health Bronze? Standard	HMO	33602TX0461164	No
MyBlue Health Bronze? Standard	HMO	33602TX0461185	No
MyBlue Health Gold? 403	HMO	33602TX0461081	No
MyBlue Health Gold? 403	HMO	33602TX0461123	No
MyBlue Health Gold? 403	HMO	33602TX0461124	No
MyBlue Health Gold? 403	HMO	33602TX0461125	No
MyBlue Health Gold? 403	HMO	33602TX0461126	No
MyBlue Health Gold? 403	HMO	33602TX0461127	No
MyBlue Health Gold? 403	HMO	33602TX0461128	No
MyBlue Health Gold? 403	HMO	33602TX0461129	No
MyBlue Health Gold? 403	HMO	33602TX0461180	No
MyBlue Health Gold? Standard	HMO	33602TX0461088	No
MyBlue Health Gold? Standard	HMO	33602TX0461166	No
MyBlue Health Gold? Standard	HMO	33602TX0461167	No
MyBlue Health Gold? Standard	HMO	33602TX0461168	No
MyBlue Health Gold? Standard	HMO	33602TX0461170	No
MyBlue Health Gold? Standard	HMO	33602TX0461171	No
MyBlue Health Gold? Standard	HMO	33602TX0461186	No
MyBlue Health Silver? 405	HMO	33602TX0461082	No
MyBlue Health Silver? 405	HMO	33602TX0461130	No
MyBlue Health Silver? 405	HMO	33602TX0461131	No
MyBlue Health Silver? 405	HMO	33602TX0461132	No
MyBlue Health Silver? 405	HMO	33602TX0461133	No
MyBlue Health Silver? 405	HMO	33602TX0461134	No
MyBlue Health Silver? 405	HMO	33602TX0461135	No
MyBlue Health Silver? 405	HMO	33602TX0461136	No
MyBlue Health Silver? 405	HMO	33602TX0461181	No
MyBlue Health Silver? Standard	HMO	33602TX0461089	No
MyBlue Health Silver? Standard	HMO	33602TX0461173	No
MyBlue Health Silver? Standard	HMO	33602TX0461174	No
MyBlue Health Silver? Standard	HMO	33602TX0461175	No
MyBlue Health Silver? Standard	HMO	33602TX0461177	No
MyBlue Health Silver? Standard	HMO	33602TX0461178	No
MyBlue Health Silver? Standard	HMO	33602TX0461187	No

Blue Cross Blue Shield of North Dakota

Plan Name	Plan Type	Plan ID	Dental Only Plan?
BlueCare Gold $25 PCP Copay ($5 Value Based Drug List)	PPO	37160ND2410005	No
BlueCare Silver $45 PCP Copay ($5 Value Based Drug List)	PPO	37160ND2410002	No
BlueDirect Bronze 100 HSA Eligible ($7500 Deductible / $5 Preventive Drug List)	PPO	37160ND2410020	No
BlueDirect Gold 90 HSA Eligible ($2600 Deductible / $5 Preventive Drug List)	PPO	37160ND2410022	No
BlueDirect Silver 80 HSA Eligible ($3500 Deductible / $5 Preventive Drug List)	PPO	37160ND2410014	No
BlueEssential Catastrophic 100 $9200 Deductible	PPO	37160ND2410021	No
BlueValue Bronze $50 PCP Copay (Standardized plan)	PPO	37160ND2410028	No
BlueValue Gold $30 PCP Copay (Standardized plan)	PPO	37160ND2410026	No
BlueValue Silver $40 PCP Copay (Standardized plan)	PPO	37160ND2410027	No
DakotaBlue Altru Gold ($5 Value Based Drug List)	PPO	37160ND2480001	No
DakotaBlue Altru Silver ($5 Value Based Drug List)	PPO	37160ND2480003	No
DakotaBlue Trinity Gold ($5 Value Based Drug List)	PPO	37160ND2480009	No
DakotaBlue Trinity Silver ($5 Value Based Drug List)	PPO	37160ND2480010	No

Blue Cross Blue Shield of Wyoming

Plan Name	Plan Type	Plan ID	Dental Only Plan?
BlueSelect Bronze Basic	PPO	11269WY0070026	No
BlueSelect Bronze Core	PPO	11269WY0070004	No
BlueSelect Expanded Bronze Standard without Kid's Dental	PPO	11269WY0170020	No
BlueSelect Gold Core	PPO	11269WY0070025	No
BlueSelect Gold HealthPlus	PPO	11269WY0070013	No
BlueSelect Gold Standard without Kid's Dental	PPO	11269WY0170017	No
BlueSelect Silver Classic	PPO	11269WY0070014	No
BlueSelect Silver Classic without Kid's Dental	PPO	11269WY0170016	No
BlueSelect Silver HealthPlus	PPO	11269WY0070016	No
BlueSelect Silver HealthPlus without Kid's Dental	PPO	11269WY0170021	No
BlueSelect Silver Standard without Kid's Dental	PPO	11269WY0170018	No

Medica

Plan Name	Plan Type	Plan ID	Dental Only Plan?
Balance by Medica Bronze $0 Copay PCP Visits	PPO	21333OK0060074	No
Balance by Medica Bronze Premier	PPO	21333OK0060051	No
Balance by Medica Catastrophic	PPO	21333OK0060013	No
Balance by Medica Expanded Bronze Standard	PPO	21333OK0060073	No
Balance by Medica Gold $0 Copay PCP Visits	PPO	21333OK0060045	No
Balance by Medica Gold Share	PPO	21333OK0060075	No
Balance by Medica Gold Standard	PPO	21333OK0060055	No
Balance by Medica Silver $0 Copay PCP Visits	PPO	21333OK0060047	No
Balance by Medica Silver Share	PPO	21333OK0060076	No
Balance by Medica Silver Standard	PPO	21333OK0060057	No
Harmony by Medica Bronze $0 Copay PCP Visits	PPO	21333OK0010041	No
Harmony by Medica Bronze $0 Copay PCP Visits + Adult Eye Exam	PPO	21333OK0070003	No
Harmony by Medica Bronze Premier	PPO	21333OK0010051	No
Harmony by Medica Bronze Premier + Adult Eye Exam	PPO	21333OK0070006	No
Harmony by Medica Catastrophic	PPO	21333OK0010013	No
Harmony by Medica Catastrophic + Adult Eye Exam	PPO	21333OK0070010	No
Harmony by Medica Expanded Bronze Standard	PPO	21333OK0010073	No
Harmony by Medica Expanded Bronze Standard + Adult Eye Exam	PPO	21333OK0070009	No
Harmony by Medica Gold $0 Copay PCP Visits	PPO	21333OK0010045	No
Harmony by Medica Gold $0 Copay PCP Visits + Adult Eye Exam	PPO	21333OK0070001	No
Harmony by Medica Gold Share	PPO	21333OK0010074	No
Harmony by Medica Gold Share + Adult Eye Exam	PPO	21333OK0070004	No
Harmony by Medica Gold Standard	PPO	21333OK0010055	No
Harmony by Medica Gold Standard + Adult Eye Exam	PPO	21333OK0070007	No
Harmony by Medica Silver $0 Copay PCP Visits	PPO	21333OK0010047	No
Harmony by Medica Silver $0 Copay PCP Visits + Adult Eye Exam	PPO	21333OK0070002	No
Harmony by Medica Silver Share	PPO	21333OK0010075	No
Harmony by Medica Silver Share + Adult Eye Exam	PPO	21333OK0070005	No
Harmony by Medica Silver Standard	PPO	21333OK0010057	No
Harmony by Medica Silver Standard + Adult Eye Exam	PPO	21333OK0070008	No

Moda Health Plan, Inc.

Plan Name	Plan Type	Plan ID	Dental Only Plan?
Moda Health Affinity Bronze 7750	EPO	39424OR1680005	No
Moda Health Affinity Bronze 9000	EPO	39424OR1660002	No
Moda Health Affinity Bronze HDHP 7500	EPO	39424OR1680007	No
Moda Health Affinity Gold 1000	EPO	39424OR1700001	No
Moda Health Affinity Gold 1500	EPO	39424OR1680008	No
Moda Health Affinity Gold 250	EPO	39424OR1690001	No
Moda Health Affinity Silver 3000	EPO	39424OR1690003	No
Moda Health Affinity Silver 3400	EPO	39424OR1680002	No
Moda Health Affinity Silver 4500	EPO	39424OR1680004	No
Moda Health Affinity Silver 6000	EPO	39424OR1660001	No
Moda Health Oregon Standard Bronze Affinity	EPO	39424OR1670003	No
Moda Health Oregon Standard Gold Affinity	EPO	39424OR1670001	No
Moda Health Oregon Standard Silver Affinity	EPO	39424OR1670002	No
Moda Pioneer Alaska Standard Bronze	PPO	73836AK0960001	No
Moda Pioneer Alaska Standard Gold	PPO	73836AK0940001	No
Moda Pioneer Alaska Standard Silver	PPO	73836AK0950001	No
Moda Pioneer Bronze 6500	PPO	73836AK0930003	No
Moda Pioneer Bronze HDHP 5500	PPO	73836AK0970002	No
Moda Pioneer Gold 1500	PPO	73836AK0930001	No
Moda Pioneer Silver 4500	PPO	73836AK0930002	No
Moda Select Bronze 8700 ($0 Virtual Urgent Care through CirrusMD)	EPO	17933TX0010006	No
Moda Select Bronze HDHP 7500	EPO	17933TX0010007	No
Moda Select Gold 1000 ($0 Virtual Urgent Care through CirrusMD)	EPO	17933TX0010001	No
Moda Select Gold 1800 ($0 Virtual Urgent Care through CirrusMD)	EPO	17933TX0010002	No
Moda Select Silver 3500 ($0 Virtual Urgent Care through CirrusMD)	EPO	17933TX0010003	No
Moda Select Silver 4800 ($0 Virtual Urgent Care through CirrusMD)	EPO	17933TX0010004	No
Moda Select Silver 6400 ($0 Virtual Urgent Care through CirrusMD)	EPO	17933TX0010005	No
Moda Select Texas Standard Bronze	EPO	17933TX0010010	No
Moda Select Texas Standard Gold	EPO	17933TX0010009	No
Moda Select Texas Standard Silver	EPO	17933TX0010008	No