Common use of Acupuncture Services Clause in Contracts

Acupuncture Services. In a provider's office - One initial evaluation per provider per plan year and acupuncture treatments up to a combined total of 12 visits per member per plan year. $45 The level of coverage is the same as network provider. Ambulance Services Ground $50 The level of coverage is the same as network provider. Air/water* - Up to the benefit limit of $3,000 per occurrence. 10% - After deductible The level of coverage is the same as network provider.

Appears in 4 contracts

Samples: Subscriber    Agreement, Subscriber    Agreement, Subscriber    Agreement

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Acupuncture Services. In a provider's office - One initial evaluation per provider per plan year and acupuncture treatments without electrical stimulation up to a combined total of 12 visits per member per plan year. $45 The level of coverage is the same as network provider. Ambulance Services Ground $50 The level of coverage is the same as network provider. Air/water* - Up to the benefit limit of $3,000 per occurrence. 10% - After deductible The level of coverage is the same as network provider.

Appears in 4 contracts

Samples: Subscriber Agreement, Subscriber Agreement, Subscriber Agreement

Acupuncture Services. In a provider's office - One initial evaluation per provider per plan year and acupuncture treatments without electrical stimulation up to a combined total of 12 visits per member per plan year. $45 The level of coverage is the same as network provider. Ambulance Services Ground $50 The level of coverage is the same as network provider. Air/water* - Up to the benefit limit of $3,000 per occurrence. 10% - After deductible $50 The level of coverage is the same as network provider.

Appears in 1 contract

Samples: Subscriber    Agreement

Acupuncture Services. In a provider's office - One initial evaluation per provider per plan year and acupuncture treatments without electrical stimulation up to a combined total of 12 visits per member per plan year. $45 30 The level of coverage is the same as network provider. Ambulance Services Ground $50 The level of coverage is the same as network provider. Air/water* - Up to the benefit limit of $3,000 per occurrence. 10% - After deductible 50 The level of coverage is the same as network provider.

Appears in 1 contract

Samples: Subscriber    Agreement

Acupuncture Services. In a provider's office - One initial evaluation per provider per plan year and acupuncture treatments without electrical stimulation up to a combined total of 12 visits per member per plan year. $45 30 The level of coverage is the same as network provider. Ambulance Services Ground $50 The level of coverage is the same as network provider. Air/water* - Up to the benefit limit of $3,000 per occurrence. 10% - After deductible $50 The level of coverage is the same as network provider.

Appears in 1 contract

Samples: Subscriber Agreement

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Acupuncture Services. In a provider's office - One initial evaluation per provider per plan year and acupuncture treatments without electrical stimulation up to a combined total of 12 visits per member per plan year. $45 The level of coverage is the same as network provider. Ambulance Services Ground $50 The level of coverage is the same as network provider. Air/water* - Up to the benefit limit of $3,000 per occurrence. 10% - After deductible The level of coverage is the same as network provider.

Appears in 1 contract

Samples: Subscriber    Agreement

Acupuncture Services. In a provider's office - One initial evaluation per provider per plan year and acupuncture treatments up to a combined total of 12 visits per member per plan year. $45 The level of coverage is the same as network provider. Ambulance Services Ground $50 The level of coverage is the same as network provider. Air/water* - Up to the benefit limit of $3,000 per occurrence. 10% - After deductible $50 The level of coverage is the same as network provider.

Appears in 1 contract

Samples: Subscriber    Agreement

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