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76.--.41.40 2013-11-11 (23:48:08)
Pregnancy/Maternity | Delivery | Anesthesia
Shield Spectrum PPOSM Plan 1500 Value
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Provider NetworkPreferred ProviderNon-Preferred Provider
Amount or percentage you pay for this service ("copay")
    30% Per Surgery, after deductible is met. Copayment maximum applies.
    50% Per Surgery, after deductible is met. Copayment maximum does not apply.
Does your payment count toward satisfying your deductible?
    Yes
    Applies to Preferred Provider deductible.
    Yes
    Applies to Non-Preferred Provider deductible.
 
 
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