Across
- 1. Optical Dispensing (not Vision Exam)
- 5. Medical Transportation Ambulance Service
- 6. Acute Inpatient Care
- 9. Durable Medical Equipment
- 11. Emergency Care
- 13. Hospital Services
- 15. Primary Care Video Visit
- 18. Outpatient (X-rays, Ultrasounds, Nuclear Medicine)
- 20. MRI Scans
- 21. Outpatient physical therapy in individual setting
- 24. Inpatient Care for Maternity
- 26. Oral/Dermal Contraceptives
- 27. Formulary Generics
- 29. Specialty Care Video Visit
- 30. Mental Health Inpatient
- 31. Outpatient Procedures - procedures provided in any setting
- 33. Provider Visits
- 34. Breast Pump
- 35. Surgery Outpatient Services
- 36. Medical Transportation Services
- 39. Home Health Services
- 42. Basic Health Plan List
- 43. Therapy Services
- 44. Formulary Brand Name
- 45. Outpatient occupational therapy in an individual setting
Down
- 1. Frame allowance every 12 or 24 months
- 2. Emergency Department Visit
- 3. Hearing Aids
- 4. Chiropractic
- 7. Gamete Intrafallopian Transfer (Infertility)
- 8. Hearing
- 10. Hospitalization
- 12. Rehabailitation: Inpatient / Outpatient
- 14. Primary Care Telephone Visit
- 16. Mail Order Incentive Generic
- 17. IVF, GIFT, and ZIFT Services
- 19. Routine Physical Exams
- 22. Hospice
- 23. Specialty Care Telephone Visit
- 25. Primary Care Visit
- 27. Mail Order Incentive Brand
- 28. Hospice Services
- 32. Specialty provider: Not primary care visits
- 37. Diagnostic and Therapeutic Imaging
- 38. Laboratory Services
- 40. Outpatient (Lab Services/Pathology)
- 41. Outpatient speech therapy in an individual setting
- 42. Prescription Drugs