| Document Date: 2014-07-30 14:51:54
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Company Supplies Office Visits / Procedures Education Laboratory / Anesthesia Laboratory / PET / / Country United States / / Currency USD / / Facility Pharmacy Not / Pharmacy Limitations / clinic If / / IndustryTerm medical transportation attention / use disorder outpatient services / health outpatient services / term in-network / use disorder inpatient services / state insurance department / inpatient services / health services / room services / excluded services / covered services / / MedicalCondition Infertility / Substance use disorder / diabetes / injury / illness / / MedicalTreatment immunization / Cosmetic Surgery / Chiropractic / Acupuncture / surgery / Bariatric surgery / / Organization U.S. Department of Health and Human Services / Employee Benefits Security Administration / Member Service / U.S. Department of Labor / / / Position Physician /surgeon / stay Physician/surgeon / Governor / illness Specialist / cost estimator / / Technology x-ray / / URL www.dol.gov/ebsa / www.bsneny.com / http /
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BlueShield of Northeastern NY: ASO RX Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: [removed][removed]Coverage for: Single/Family | Plan Type: RX