Plan details: 201143 100 PPO+ ITW CORPORATE DP_XTW (174)

Plan details for 201143 100 PPO+ ITW CORPORATE DP_XTW (ID: 361258310)
Appears in: 2026-082026-062026-05
Date
Schema
Filename
# of Parts
# of Parts Available
Total source size
2026-08-01ALLOWED_AMOUNT2026-08-13_Blue-Cross-and-Blue-Shield...100 Bytes
2026-08-01IN_NETWORK2026-08-14_Blue-Cross-and-Blue-Shield...100 Bytes
2026-08-01IN_NETWORK2026-09_020_02I0_in-network-rates200 Bytes
2026-08-01IN_NETWORK2026-09_030_03J0_in-network-rates100 Bytes
2026-08-01IN_NETWORK2026-09_040_05C0_in-network-rates700 Bytes
2026-08-01IN_NETWORK2026-09_042_04B0_in-network-rates100 Bytes
2026-08-01IN_NETWORK2026-09_051_06B0_in-network-rates500 Bytes
2026-08-01IN_NETWORK2026-09_062_07B0_in-network-rates200 Bytes
2026-08-01IN_NETWORK2026-09_070_09B0_in-network-rates200 Bytes
2026-08-01IN_NETWORK2026-09_102_11B0_in-network-rates700 Bytes
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