BlueCross BlueShield Plan Name Here Subacriber Name: JOHN DOE Subecriber ID: YPPW123456789 Group No: RxBin/Group: 123456 Date lesued: O0/00/00 01 123456780

Understanding Health Insurance: A Guide to Billing and Reimbursement
14th Edition
ISBN:9781337679480
Author:GREEN
Publisher:GREEN
Chapter8: Hcpcs Level Ii Coding
Section: Chapter Questions
Problem 24R
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BlueCross
BlueShield
Plan Name Here
Subecriber Name:
JOHN DOE
Subecriber ID:
YPPW123456789
01
Group No:
RxBin/Group: 123456
Date lesued: 00/00/00
123456780
In-Network Member Responaibility:
Primary
Specialiet
Urgent Care
ER
Preaoription Drug $8/S35/S50/25%
Preventive Care
Members:
JANE
$25
$50
$50
$200
02
03
SAM
No Copay
RA
Dental Blue
Blue
O Physician Hospital Organization
Preferred Provider Organization
O Exclusive Provider Organization
Health Maintenance Organization
Transcribed Image Text:BlueCross BlueShield Plan Name Here Subecriber Name: JOHN DOE Subecriber ID: YPPW123456789 01 Group No: RxBin/Group: 123456 Date lesued: 00/00/00 123456780 In-Network Member Responaibility: Primary Specialiet Urgent Care ER Preaoription Drug $8/S35/S50/25% Preventive Care Members: JANE $25 $50 $50 $200 02 03 SAM No Copay RA Dental Blue Blue O Physician Hospital Organization Preferred Provider Organization O Exclusive Provider Organization Health Maintenance Organization
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