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CDPHP Member Enrollment Form and SBC - Dutchess Community ...

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No Charge Not Covered None.No ChargeNot CoveredNone.$20 co-pay/visit Not Covered None.No ChargeNot CoveredNone.$20 co-pay/visit Not Covered None.No ChargeNot CoveredNone.No Charge Not Covered None.No Charge Not Covered None.No Charge Not Covered None.No ChargeNot CoveredLimited to 60 days inpatient physical rehabilitation perbenefit period.<strong>SBC</strong>-Id : 14024 of 8

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