Plan details: DRAGONFLY THERAPYHSA Aetna Choice POS II (6)

Name: DRAGONFLY THERAPYHSA Aetna Choice POS II — Aetna CVS - Fully Insured Under 100 Employees negotiated rates
Creator: Aetna CVS - Fully Insured Under 100 Employees
License: https://www.ecfr.gov/current/title-45/part-147/section-147.212#p-147.212(b)(2)

Plan details for DRAGONFLY THERAPYHSA Aetna Choice POS II (ID: 203621232)

Appears in: 2025-022025-012024-11

Date	Schema	Filename	# of Parts	# of Parts Available	Total source size
2025-02-01	ALLOWED_AMOUNT	2025-02-05_pl-24j-tr25_Aetna-Life-Ins...	1	1	160 Bytes
2025-02-01	IN_NETWORK	2025-02-05_pl-24j-tr25_Aetna-Life-Ins...	1	1	4.8 GB
2025-01-01	ALLOWED_AMOUNT	2025-01-05_pl-2ti-tr25_Aetna-Life-Ins...	1	1	160 Bytes
2025-01-01	IN_NETWORK	2025-01-05_pl-2ti-tr25_Aetna-Life-Ins...	1	1	4.89 GB
2024-11-01	IN_NETWORK	2024-11-05_pl-1k8-tr25_Aetna-Life-Ins...	1	1	4.25 GB
2024-11-01	ALLOWED_AMOUNT	2024-11-05_pl-1k8-tr25_Aetna-Life-Ins...	1	1	160 Bytes

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