Page 75 - Appendices to Donald Pender's Evaluation
P. 75
PREVENTIVE SERVICES
Health care to prevent illness or detect illness at an early stage, when treatment is likely
to work best (like Pap tests, u shots, and screening mammograms).
Learn more about your costs for preventive services
Preventive services $0 copay
AMBULANCE
Ground ambulance $150 copay
THERAPY SERVICES
Occupational therapy visit $0 copay Limits apply
Physical therapy & speech $0 copay Limits apply
& language therapy visit
MENTAL HEALTH SERVICES
Outpatient group therapy $30 copay Limits apply
with a psychiatrist
Outpatient individual $30 copay Limits apply
therapy with a psychiatrist
Outpatient group therapy $30 copay Limits apply
visit
Outpatient individual $30 copay Limits apply
therapy visit
