Page 68 - Appendices for Barbara Pender
P. 68
OPIOID TREATMENT PROGRAM SERVICES
Opioid treatment program $0 copay Limits apply
services In-network: 0% coinsurance
OTHER SERVICES
Durable medical 0-20% coinsurance per item Limits apply
equipment (like
wheelchairs & oxygen)
Prosthetics (like braces, $0 copay Limits apply
arti cial limbs)
Dialysis In- 10%-20% Limits apply
network: coinsurance
Diabetes supplies $0 copay Limits apply
