Code | Display | Definition |
1 | Medical Care | Medical Care. |
2 | Surgical | Surgical. |
3 | Consultation | Consultation. |
4 | Diagnostic XRay | Diagnostic XRay. |
5 | Diagnostic Lab | Diagnostic Lab. |
14 | Renal Supplies | Renal Supplies excluding Dialysis. |
23 | Diagnostic Dental | Diagnostic Dental. |
24 | Periodontics | Periodontics. |
25 | Restorative | Restorative. |
26 | Endodontics | Endodontics. |
27 | Maxillofacial Prosthetics | Maxillofacial Prosthetics. |
28 | Adjunctive Dental Services | Adjunctive Dental Services. |
30 | Health Benefit Plan Coverage | Health Benefit Plan Coverage. |
35 | Dental Care | Dental Care. |
36 | Dental Crowns | Dental Crowns. |
37 | Dental Accident | Dental Accident. |
49 | Hospital Room and Board | Hospital Room and Board. |
55 | Major Medical | Major Medical. |
56 | Medically Related Transportation | Medically Related Transportation. |
61 | In-vitro Fertilization | In-vitro Fertilization. |
62 | MRI Scan | MRI Scan. |
63 | Donor Procedures | Donor Procedures such as organ harvest. |
69 | Maternity | Maternity. |
76 | Renal Dialysis | Renal dialysis. |
F1 | Medical Coverage | Medical Coverage. |
F3 | Dental Coverage | Dental Coverage. |
F4 | Hearing Coverage | Hearing Coverage. |
F6 | Vision Coverage | Vision Coverage. |