SCHEDULE OF BENEFITS - nib
SCHEDULE OF BENEFITS - nib
SCHEDULE OF BENEFITS - nib
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
Item No Benefit Item No Benefit Item No Benefit Item No Benefit<br />
47360 $189.05 47477 $337.60 47603 $809.90 47741 $688.75<br />
47363 $283.30 47480 $674.90 47606 $337.60 47753 $583.10<br />
47366 $378.00 47483 $809.90 47609 $506.20 47756 $583.10<br />
47369 $243.05 47486 $1,349.95 47612 $587.20 47762 $342.40<br />
47372 $404.85 47489 $2,024.95 47615 $674.90 47765 $562.20<br />
47375 $539.95 47492 $337.60 47618 $843.85 47768 $688.75<br />
47378 $243.05 47495 $674.90 47621 $587.20 47771 $791.30<br />
47381 $364.45 47498 $1,012.40 47624 $809.90 47774 $624.65<br />
47384 $485.90 47501 $1,349.95 47627 $229.40 47777 $624.65<br />
47385 $418.30 47504 $2,024.95 47630 $485.90 47780 $812.10<br />
47386 $674.90 47507 $2,024.95 47633 $161.85 47783 $812.10<br />
47387 $391.35 47510 $2,024.95 47636 $243.05 47786 $1,030.55<br />
47390 $587.20 47513 $539.95 47639 $324.05 47789 $1,030.55<br />
47393 $782.85 47516 $620.80 47642 $216.15 47900 $243.05<br />
47396 $269.90 47519 $1,242.05 47645 $324.05 47903 $337.60<br />
47399 $539.95 47522 $1,080.05 47648 $431.65 47904 $81.00<br />
47402 $404.85 47525 $1,242.05 47651 $337.60 47906 $161.85<br />
47405 $269.90 47528 $1,080.05 47654 $506.20 47912 $81.00<br />
47408 $539.95 47531 $1,376.85 47657 $674.90 47915 $243.05<br />
47411 $161.85 47534 $1,552.45 47663 $202.50 47916 $122.05<br />
47414 $324.05 47537 $620.80 47666 $337.60 47918 $337.60<br />
47417 $378.00 47540 $310.40 47672 $161.85 47920 $545.95<br />
47420 $742.50 47543 $324.05 47678 $243.05 47921 $161.85<br />
47423 $310.40 47546 $485.90 47681 $61.60 47924 $54.00<br />
47426 $465.70 47549 $648.00 47684 $1,080.05 47927 $202.50<br />
47429 $620.80 47552 $539.95 47687 $1,889.60 47930 $378.00<br />
47432 $776.15 47555 $809.90 47690 $1,484.85 47933 $296.80<br />
47435 $594.05 47558 $1,080.05 47693 $1,889.60 47936 $364.45<br />
47438 $945.10 47561 $391.35 47696 $539.95 47948 $229.40<br />
47441 $1,181.15 47564 $587.20 47699 $2,160.05 47951 $269.90<br />
47444 $324.05 47565 $1,021.50 47702 $2,699.95 47954 $539.95<br />
47447 $485.90 47566 $1,302.05 47703 $61.60 47957 $404.85<br />
47450 $648.00 47567 $681.60 47705 $404.85 47960 $189.05<br />
47451 $781.15 47570 $782.85 47708 $310.40 47963 $310.40<br />
47453 $378.00 47573 $978.65 47711 $459.10 47966 $620.80<br />
47456 $567.15 47576 $161.85 47714 $344.20 47969 $378.00<br />
47459 $755.95 47579 $229.40 47717 $607.60 47972 $301.95<br />
47462 $161.85 47582 $472.55 47720 $607.60 47975 $529.30<br />
47465 $324.05 47585 $607.60 47723 $607.60 47978 $321.45<br />
47466 $161.85 47588 $1,889.60 47726 $202.50 47981 $215.85<br />
47467 $324.05 47591 $2,295.15 47729 $337.60 47982 $523.25<br />
47468 $620.80 47594 $310.40 47732 $539.95 48200 $1,080.05<br />
47471 $61.60 47597 $465.70 47735 $61.70 48203 $1,309.50<br />
47474 $269.90 47600 $620.80 47738 $337.60 48206 $810.75<br />
47360 to 48206<br />
| MediGap 2010<br />
27
Change language