DR. DONALD D POTTER DC
Accepted Insurance Health Plans for NPI 1700961570
Chiropractor in Ponca City, OK
NPI Status: Active since October 27, 2006
Contact Information
300 N 5TH ST
PONCA CITY, OK
ZIP 74601
Phone: (580) 762-1291
Fax: (580) 762-0379
Accepted Health Plans and Insurance Coverage
List of insurance companies accepted by DR. DONALD D POTTER DC. 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.
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Altru Prime by Medica Bronze $0 Copay PCP Visits | HMO | 73751ND0120041 | No |
| Altru Prime by Medica Bronze $0 Copay PCP Visits | HMO | 73751ND0120041 | No |
| Altru Prime by Medica Bronze Share | HMO | 73751ND0120029 | No |
| Altru Prime by Medica Bronze Share | HMO | 73751ND0120029 | No |
| Altru Prime by Medica Expanded Bronze Standard | HMO | 73751ND0120073 | No |
| Altru Prime by Medica Expanded Bronze Standard | HMO | 73751ND0120073 | No |
| Altru Prime by Medica Gold $0 Copay PCP Visits | HMO | 73751ND0120045 | No |
| Altru Prime by Medica Gold $0 Copay PCP Visits | HMO | 73751ND0120045 | No |
| Altru Prime by Medica Gold Share | HMO | 73751ND0120074 | No |
| Altru Prime by Medica Gold Standard | HMO | 73751ND0120055 | No |
| Altru Prime by Medica Gold Standard | HMO | 73751ND0120055 | No |
| Altru Prime by Medica Silver $0 Copay PCP Visits | HMO | 73751ND0120047 | No |
| Altru Prime by Medica Silver $0 Copay PCP Visits | HMO | 73751ND0120047 | No |
| Altru Prime by Medica Silver Share | HMO | 73751ND0120076 | No |
| Altru Prime by Medica Silver Standard | HMO | 73751ND0120057 | No |
| Altru Prime by Medica Silver Standard | HMO | 73751ND0120057 | No |
| Balance by Medica Bronze $0 Copay PCP Visits | PPO | 21333OK0060074 | No |
| Balance by Medica Bronze Premier | PPO | 21333OK0060051 | No |
| Balance by Medica Bronze Premier | PPO | 21333OK0060051 | No |
| Balance by Medica Catastrophic | PPO | 21333OK0060013 | No |
| Balance by Medica Catastrophic | PPO | 21333OK0060013 | No |
| Balance by Medica Expanded Bronze Standard | PPO | 21333OK0060073 | 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 $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 Gold Standard | PPO | 21333OK0060055 | No |
| Balance by Medica Silver $0 Copay PCP Visits | PPO | 21333OK0060047 | 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 |
| Balance by Medica Silver Standard | PPO | 21333OK0060057 | No |
| Elevate by Medica Bronze $0 Copay PCP Visits | EPO | 20305NE0030041 | No |
| Elevate by Medica Bronze $0 Copay PCP Visits | EPO | 20305NE0030041 | No |
| Elevate by Medica Bronze $0 Copay PCP Visits | EPO | 93078IA0050041 | No |
| Elevate by Medica Bronze Premier | EPO | 20305NE0030051 | No |
| Elevate by Medica Bronze Premier | EPO | 20305NE0030051 | No |
| Elevate by Medica Bronze Share | EPO | 93078IA0050029 | No |
| Elevate by Medica Expanded Bronze Standard | EPO | 20305NE0030073 | No |
| Elevate by Medica Expanded Bronze Standard | EPO | 20305NE0030073 | No |
| Elevate by Medica Expanded Bronze Standard | EPO | 93078IA0050073 | No |
| Elevate by Medica Gold $0 Copay PCP Visits | EPO | 20305NE0030045 | No |
| Elevate by Medica Gold $0 Copay PCP Visits | EPO | 20305NE0030045 | No |
| Elevate by Medica Gold $0 Copay PCP Visits | EPO | 93078IA0050045 | No |
| Elevate by Medica Gold Share | EPO | 20305NE0030025 | No |
| Elevate by Medica Gold Share | EPO | 20305NE0030025 | No |
| Elevate by Medica Gold Standard | EPO | 20305NE0030055 | No |
| Elevate by Medica Gold Standard | EPO | 20305NE0030055 | No |
| Elevate by Medica Gold Standard | EPO | 93078IA0050055 | No |
| Elevate by Medica Silver $0 Copay PCP Visits | EPO | 20305NE0030047 | No |
| Elevate by Medica Silver $0 Copay PCP Visits | EPO | 20305NE0030047 | No |
| Elevate by Medica Silver $0 Copay PCP Visits | EPO | 93078IA0050047 | No |
| Elevate by Medica Silver Share | EPO | 20305NE0030074 | No |
| Elevate by Medica Silver Standard | EPO | 20305NE0030057 | No |
| Elevate by Medica Silver Standard | EPO | 20305NE0030057 | No |
| Elevate by Medica Silver Standard | EPO | 93078IA0050057 | No |
| Engage by Medica Bronze HSA | EPO | 57845WI0050011 | No |
| Engage by Medica Bronze HSA | EPO | 57845WI0050011 | No |
| Engage by Medica Bronze Share | EPO | 57845WI0050029 | No |
| Engage by Medica Bronze Share | EPO | 57845WI0050029 | No |
| Engage by Medica Expanded Bronze Standard | EPO | 57845WI0050073 | No |
| Engage by Medica Expanded Bronze Standard | EPO | 57845WI0050073 | No |
| Engage by Medica Gold $0 Copay PCP Visits | EPO | 57845WI0050074 | No |
| Engage by Medica Gold Share | EPO | 57845WI0050076 | No |
| Engage by Medica Gold Standard | EPO | 57845WI0050055 | No |
| Engage by Medica Gold Standard | EPO | 57845WI0050055 | No |
| Engage by Medica Silver $0 Copay PCP Visits | EPO | 57845WI0050075 | No |
| Engage by Medica Silver Share | EPO | 57845WI0050027 | No |
| Engage by Medica Silver Share | EPO | 57845WI0050027 | No |
| Engage by Medica Silver Standard | EPO | 57845WI0050057 | No |
| Engage by Medica Silver Standard | EPO | 57845WI0050057 | No |
| Essentia Choice Care with Medica Bronze $0 Copay PCP Visits | HMO | 73751ND0140041 | No |
| Essentia Choice Care with Medica Bronze $0 Copay PCP Visits | HMO | 73751ND0140041 | No |
| Essentia Choice Care with Medica Bronze HSA | EPO | 57845WI0060011 | No |
| Essentia Choice Care with Medica Bronze HSA | EPO | 57845WI0060011 | No |
| Essentia Choice Care with Medica Bronze Share | EPO | 57845WI0060029 | No |
| Essentia Choice Care with Medica Bronze Share | EPO | 57845WI0060029 | No |
| Essentia Choice Care with Medica Bronze Share | HMO | 73751ND0140029 | No |
| Essentia Choice Care with Medica Bronze Share | HMO | 73751ND0140029 | No |
| Essentia Choice Care with Medica Expanded Bronze Standard | EPO | 57845WI0060073 | No |
| Essentia Choice Care with Medica Expanded Bronze Standard | EPO | 57845WI0060073 | No |
| Essentia Choice Care with Medica Expanded Bronze Standard | HMO | 73751ND0140073 | No |
| Essentia Choice Care with Medica Expanded Bronze Standard | HMO | 73751ND0140073 | No |
| Essentia Choice Care with Medica Gold $0 Copay PCP Visits | EPO | 57845WI0060074 | No |
| Essentia Choice Care with Medica Gold $0 Copay PCP Visits | HMO | 73751ND0140045 | No |
| Essentia Choice Care with Medica Gold $0 Copay PCP Visits | HMO | 73751ND0140045 | No |
| Essentia Choice Care with Medica Gold Share | EPO | 57845WI0060076 | No |
| Essentia Choice Care with Medica Gold Share | HMO | 73751ND0140074 | No |
| Essentia Choice Care with Medica Gold Standard | EPO | 57845WI0060055 | No |
| Essentia Choice Care with Medica Gold Standard | EPO | 57845WI0060055 | No |
| Essentia Choice Care with Medica Gold Standard | HMO | 73751ND0140055 | No |
| Essentia Choice Care with Medica Gold Standard | HMO | 73751ND0140055 | No |
| Essentia Choice Care with Medica Silver $0 Copay PCP Visits | EPO | 57845WI0060075 | No |
| Essentia Choice Care with Medica Silver $0 Copay PCP Visits | HMO | 73751ND0140047 | No |
| Essentia Choice Care with Medica Silver $0 Copay PCP Visits | HMO | 73751ND0140047 | No |
| Essentia Choice Care with Medica Silver Share | EPO | 57845WI0060027 | No |
| Essentia Choice Care with Medica Silver Share | EPO | 57845WI0060027 | No |
| Essentia Choice Care with Medica Silver Share | HMO | 73751ND0140076 | No |
| Essentia Choice Care with Medica Silver Standard | EPO | 57845WI0060057 | No |
| Essentia Choice Care with Medica Silver Standard | EPO | 57845WI0060057 | No |
| Essentia Choice Care with Medica Silver Standard | HMO | 73751ND0140057 | No |
| Essentia Choice Care with Medica Silver Standard | HMO | 73751ND0140057 | No |
| Harmony by Medica Bronze $0 Copay PCP Visits | PPO | 21333OK0010041 | 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 | 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 | 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 | 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 | 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 | 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 | 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 | PPO | 21333OK0010057 | No |
| Harmony by Medica Silver Standard + Adult Eye Exam | PPO | 21333OK0070008 | No |
| Inspire by Medica Bronze $0 Copay PCP Visits | EPO | 93078IA0070074 | No |
| Inspire by Medica Bronze Share | EPO | 93078IA0070029 | No |
| Inspire by Medica Bronze Share | EPO | 93078IA0070029 | No |
| Inspire by Medica Expanded Bronze Standard | EPO | 93078IA0070073 | No |
| Inspire by Medica Expanded Bronze Standard | EPO | 93078IA0070073 | No |
| Inspire by Medica Gold $0 Copay PCP Visits | EPO | 93078IA0070045 | No |
| Inspire by Medica Gold $0 Copay PCP Visits | EPO | 93078IA0070045 | No |
| Inspire by Medica Gold Share | EPO | 93078IA0070075 | No |
| Inspire by Medica Gold Standard | EPO | 93078IA0070055 | No |
| Inspire by Medica Gold Standard | EPO | 93078IA0070055 | No |
| Inspire by Medica Silver $0 Copay PCP Visits | EPO | 93078IA0070047 | No |
| Inspire by Medica Silver $0 Copay PCP Visits | EPO | 93078IA0070047 | No |
| Inspire by Medica Silver Share | EPO | 93078IA0070027 | No |
| Inspire by Medica Silver Share | EPO | 93078IA0070027 | No |
| Inspire by Medica Silver Standard | EPO | 93078IA0070057 | No |
| Inspire by Medica Silver Standard | EPO | 93078IA0070057 | No |
| Medica Individual Choice Bronze $0 Copay PCP Visits | HMO | 73751ND0130041 | No |
| Medica Individual Choice Bronze $0 Copay PCP Visits | HMO | 73751ND0130041 | No |
| Medica Individual Choice Bronze HSA | EPO | 57845WI0040011 | No |
| Medica Individual Choice Bronze HSA | EPO | 57845WI0040011 | No |
| Medica Individual Choice Bronze Share | EPO | 57845WI0040029 | No |
| Medica Individual Choice Bronze Share | EPO | 57845WI0040029 | No |
| Medica Individual Choice Bronze Share | HMO | 73751ND0130029 | No |
| Medica Individual Choice Bronze Share | HMO | 73751ND0130029 | No |
| Medica Individual Choice Expanded Bronze Standard | EPO | 57845WI0040073 | No |
| Medica Individual Choice Expanded Bronze Standard | EPO | 57845WI0040073 | No |
| Medica Individual Choice Expanded Bronze Standard | HMO | 73751ND0130073 | No |
| Medica Individual Choice Expanded Bronze Standard | HMO | 73751ND0130073 | No |
| Medica Individual Choice Gold $0 Copay PCP Visits | EPO | 57845WI0040074 | No |
| Medica Individual Choice Gold $0 Copay PCP Visits | HMO | 73751ND0130045 | No |
| Medica Individual Choice Gold $0 Copay PCP Visits | HMO | 73751ND0130045 | No |
| Medica Individual Choice Gold Share | EPO | 57845WI0040076 | No |
| Medica Individual Choice Gold Share | HMO | 73751ND0130074 | No |
| Medica Individual Choice Gold Standard | EPO | 57845WI0040055 | No |
| Medica Individual Choice Gold Standard | EPO | 57845WI0040055 | No |
| Medica Individual Choice Gold Standard | HMO | 73751ND0130055 | No |
| Medica Individual Choice Gold Standard | HMO | 73751ND0130055 | No |
| Medica Individual Choice Silver $0 Copay PCP Visits | EPO | 57845WI0040075 | No |
| Medica Individual Choice Silver $0 Copay PCP Visits | HMO | 73751ND0130047 | No |
| Medica Individual Choice Silver $0 Copay PCP Visits | HMO | 73751ND0130047 | No |
| Medica Individual Choice Silver Share | EPO | 57845WI0040027 | No |
| Medica Individual Choice Silver Share | EPO | 57845WI0040027 | No |
| Medica Individual Choice Silver Share | HMO | 73751ND0130076 | No |
| Medica Individual Choice Silver Standard | EPO | 57845WI0040057 | No |
| Medica Individual Choice Silver Standard | EPO | 57845WI0040057 | No |
| Medica Individual Choice Silver Standard | HMO | 73751ND0130057 | No |
| Medica Individual Choice Silver Standard | HMO | 73751ND0130057 | No |
| Medica Insure Bronze $0 Copay PCP Visits | EPO | 93078IA0060041 | No |
| Medica Insure Bronze $0 Copay PCP Visits | EPO | 93078IA0060041 | No |
| Medica Insure Bronze Premier | EPO | 20305NE0040051 | No |
| Medica Insure Bronze Premier | EPO | 20305NE0040051 | No |
| Medica Insure Bronze Share | EPO | 20305NE0040029 | No |
| Medica Insure Bronze Share | EPO | 20305NE0040029 | No |
| Medica Insure Bronze Share | EPO | 93078IA0060029 | No |
| Medica Insure Bronze Share | EPO | 93078IA0060029 | No |
| Medica Insure Expanded Bronze Standard | EPO | 20305NE0040073 | No |
| Medica Insure Expanded Bronze Standard | EPO | 20305NE0040073 | No |
| Medica Insure Expanded Bronze Standard | EPO | 93078IA0060073 | No |
| Medica Insure Expanded Bronze Standard | EPO | 93078IA0060073 | No |
| Medica Insure Gold $0 Copay PCP Visits | EPO | 20305NE0040045 | No |
| Medica Insure Gold $0 Copay PCP Visits | EPO | 20305NE0040045 | No |
| Medica Insure Gold $0 Copay PCP Visits | EPO | 93078IA0060045 | No |
| Medica Insure Gold $0 Copay PCP Visits | EPO | 93078IA0060045 | No |
| Medica Insure Gold Share | EPO | 20305NE0040025 | No |
| Medica Insure Gold Share | EPO | 20305NE0040025 | No |
| Medica Insure Gold Share | EPO | 93078IA0060074 | No |
| Medica Insure Gold Standard | EPO | 20305NE0040055 | No |
| Medica Insure Gold Standard | EPO | 20305NE0040055 | No |
| Medica Insure Gold Standard | EPO | 93078IA0060055 | No |
| Medica Insure Gold Standard | EPO | 93078IA0060055 | No |
| Medica Insure Silver $0 Copay PCP Visits | EPO | 20305NE0040047 | No |
| Medica Insure Silver $0 Copay PCP Visits | EPO | 20305NE0040047 | No |
| Medica Insure Silver $0 Copay PCP Visits | EPO | 93078IA0060047 | No |
| Medica Insure Silver $0 Copay PCP Visits | EPO | 93078IA0060047 | No |
| Medica Insure Silver Share | EPO | 20305NE0040027 | No |
| Medica Insure Silver Share | EPO | 20305NE0040027 | No |
| Medica Insure Silver Share | EPO | 93078IA0060027 | No |
| Medica Insure Silver Share | EPO | 93078IA0060027 | No |
| Medica Insure Silver Standard | EPO | 20305NE0040057 | No |
| Medica Insure Silver Standard | EPO | 20305NE0040057 | No |
| Medica Insure Silver Standard | EPO | 93078IA0060057 | No |
| Medica Insure Silver Standard | EPO | 93078IA0060057 | No |
| Medica with CHI Health Bronze $0 Copay PCP Visits | EPO | 20305NE0050074 | No |
| Medica with CHI Health Bronze $0 Copay PCP Visits | EPO | 93078IA0080041 | No |
| Medica with CHI Health Bronze $0 Copay PCP Visits | EPO | 93078IA0080041 | No |
| Medica with CHI Health Bronze $0 Copay PCP Visits + Adult Eye Exam | EPO | 20305NE0100003 | No |
| Medica with CHI Health Bronze $0 Copay PCP Visits + Adult Eye Exam | EPO | 93078IA0130003 | No |
| Medica with CHI Health Bronze Premier | EPO | 20305NE0050051 | No |
| Medica with CHI Health Bronze Premier | EPO | 20305NE0050051 | No |
| Medica with CHI Health Bronze Premier + Adult Eye Exam | EPO | 20305NE0100006 | No |
| Medica with CHI Health Bronze Share | EPO | 93078IA0080029 | No |
| Medica with CHI Health Bronze Share | EPO | 93078IA0080029 | No |
| Medica with CHI Health Bronze Share + Adult Eye Exam | EPO | 93078IA0130006 | No |
| Medica with CHI Health Expanded Bronze Standard | EPO | 20305NE0050073 | No |
| Medica with CHI Health Expanded Bronze Standard | EPO | 20305NE0050073 | No |
| Medica with CHI Health Expanded Bronze Standard | EPO | 93078IA0080073 | No |
| Medica with CHI Health Expanded Bronze Standard | EPO | 93078IA0080073 | No |
| Medica with CHI Health Expanded Bronze Standard + Adult Eye Exam | EPO | 20305NE0100009 | No |
| Medica with CHI Health Expanded Bronze Standard + Adult Eye Exam | EPO | 93078IA0130009 | No |
| Medica with CHI Health Gold $0 Copay PCP Visits | EPO | 20305NE0050045 | No |
| Medica with CHI Health Gold $0 Copay PCP Visits | EPO | 20305NE0050045 | No |
| Medica with CHI Health Gold $0 Copay PCP Visits | EPO | 93078IA0080045 | No |
| Medica with CHI Health Gold $0 Copay PCP Visits | EPO | 93078IA0080045 | No |
| Medica with CHI Health Gold $0 Copay PCP Visits + Adult Eye Exam | EPO | 20305NE0100001 | No |
| Medica with CHI Health Gold $0 Copay PCP Visits + Adult Eye Exam | EPO | 93078IA0130001 | No |
| Medica with CHI Health Gold Share | EPO | 20305NE0050075 | No |
| Medica with CHI Health Gold Share | EPO | 93078IA0080074 | No |
| Medica with CHI Health Gold Share + Adult Eye Exam | EPO | 20305NE0100004 | No |
| Medica with CHI Health Gold Share + Adult Eye Exam | EPO | 93078IA0130004 | No |
| Medica with CHI Health Gold Standard | EPO | 20305NE0050055 | No |
| Medica with CHI Health Gold Standard | EPO | 20305NE0050055 | No |
| Medica with CHI Health Gold Standard | EPO | 93078IA0080055 | No |
| Medica with CHI Health Gold Standard | EPO | 93078IA0080055 | No |
| Medica with CHI Health Gold Standard + Adult Eye Exam | EPO | 20305NE0100007 | No |
| Medica with CHI Health Gold Standard + Adult Eye Exam | EPO | 93078IA0130007 | No |
| Medica with CHI Health Silver $0 Copay PCP Visits | EPO | 20305NE0050047 | No |
| Medica with CHI Health Silver $0 Copay PCP Visits | EPO | 20305NE0050047 | No |
| Medica with CHI Health Silver $0 Copay PCP Visits | EPO | 93078IA0080047 | No |
| Medica with CHI Health Silver $0 Copay PCP Visits | EPO | 93078IA0080047 | No |
| Medica with CHI Health Silver $0 Copay PCP Visits + Adult Eye Exam | EPO | 20305NE0100002 | No |
| Medica with CHI Health Silver $0 Copay PCP Visits + Adult Eye Exam | EPO | 93078IA0130002 | No |
| Medica with CHI Health Silver Share | EPO | 20305NE0050027 | No |
| Medica with CHI Health Silver Share | EPO | 20305NE0050027 | No |
| Medica with CHI Health Silver Share | EPO | 93078IA0080075 | No |
| Medica with CHI Health Silver Share + Adult Eye Exam | EPO | 20305NE0100005 | No |
| Medica with CHI Health Silver Share + Adult Eye Exam | EPO | 93078IA0130005 | No |
| Medica with CHI Health Silver Standard | EPO | 20305NE0050057 | No |
| Medica with CHI Health Silver Standard | EPO | 20305NE0050057 | No |
| Medica with CHI Health Silver Standard | EPO | 93078IA0080057 | No |
| Medica with CHI Health Silver Standard | EPO | 93078IA0080057 | No |
| Medica with CHI Health Silver Standard + Adult Eye Exam | EPO | 20305NE0100008 | No |
| Medica with CHI Health Silver Standard + Adult Eye Exam | EPO | 93078IA0130008 | No |