| 44113NY0440051 |
Anthem Dental Family Enhanced, NS, OON, Prime Network, Dep25, Adult/Family Dental, WP |
2024 |
NYN001
|
Feb 12, 2024 |
| 44113NY0440052 |
Anthem Dental Family Enhanced, NS, OON, Prime Network, Dep25, Adult/Family Dental, WP |
2024 |
NYN007
|
Feb 12, 2024 |
| 44113NY0440003 |
Anthem Dental Family, NS, OON, Prime Network, Dep25, Adult/Family Dental, WP |
2024 |
NYN007
|
Feb 12, 2024 |
| 44113NY0440001 |
Anthem Dental Family, NS, OON, Prime Network, Dep25, Adult/Family Dental, WP |
2024 |
NYN001
|
Feb 12, 2024 |
| 44113NY0440005 |
Anthem Dental Family Value, NS, OON, Prime Network, Dep25, Adult/Family Dental, WP |
2024 |
NYN007
|
Feb 12, 2024 |
| 44113NY0440004 |
Anthem Dental Family Value, NS, OON, Prime Network, Dep25, Adult/Family Dental, WP |
2024 |
NYN001
|
Feb 12, 2024 |
| 44113NY0420003 |
Anthem Dental Pediatric, ST, OON, Prime Network, Pediatric Dental |
2024 |
NYN007
|
Feb 12, 2024 |
| 44113NY0420001 |
Anthem Dental Pediatric, ST, OON, Prime Network, Pediatric Dental |
2024 |
NYN001
|
Feb 12, 2024 |
| 44113NY0370097 |
Anthem EPO 25/0%/8700 Gold INN Blue Access Dep 25 Wellness Pediatric Dental DP C Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370105 |
Anthem EPO 25/0%/8700 Gold INN Blue Access Dep 25 Wellness Pediatric Dental DP C Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370100 |
Anthem EPO 25/0%/8700 Gold INN Blue Access Dep 25 Wellness Pediatric Dental DP C Opt Out RE A Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370108 |
Anthem EPO 25/0%/8700 Gold INN Blue Access Dep 25 Wellness Pediatric Dental DP C Opt Out RE A Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370112 |
Anthem EPO 25/0%/8700 Gold INN Blue Access Dep 25 Wellness Pediatric Dental DP FP |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370104 |
Anthem EPO 25/0%/8700 Gold INN Blue Access Dep 25 Wellness Pediatric Dental DP FP |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370111 |
Anthem EPO 25/0%/8700 Gold INN Blue Access Dep 25 Wellness Pediatric Dental DP FP RE A Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370103 |
Anthem EPO 25/0%/8700 Gold INN Blue Access Dep 25 Wellness Pediatric Dental DP FP RE A Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370098 |
Anthem EPO 25/0%/8700 Gold INN Blue Access Dep 29 Wellness Pediatric Dental DP C Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370106 |
Anthem EPO 25/0%/8700 Gold INN Blue Access Dep 29 Wellness Pediatric Dental DP C Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370099 |
Anthem EPO 25/0%/8700 Gold INN Blue Access Dep 29 Wellness Pediatric Dental DP C Opt Out RE A Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370107 |
Anthem EPO 25/0%/8700 Gold INN Blue Access Dep 29 Wellness Pediatric Dental DP C Opt Out RE A Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370101 |
Anthem EPO 25/0%/8700 Gold INN Blue Access Dep 29 Wellness Pediatric Dental DP FP |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370109 |
Anthem EPO 25/0%/8700 Gold INN Blue Access Dep 29 Wellness Pediatric Dental DP FP |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370110 |
Anthem EPO 25/0%/8700 Gold INN Blue Access Dep 29 Wellness Pediatric Dental DP FP RE A Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370102 |
Anthem EPO 25/0%/8700 Gold INN Blue Access Dep 29 Wellness Pediatric Dental DP FP RE A Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370001 |
Anthem EPO 300/10%/3200 Platinum INN Blue Access Dep 25 Wellness Pediatric Dental DP C Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370009 |
Anthem EPO 300/10%/3200 Platinum INN Blue Access Dep 25 Wellness Pediatric Dental DP C Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370012 |
Anthem EPO 300/10%/3200 Platinum INN Blue Access Dep 25 Wellness Pediatric Dental DP C Opt Out RE A Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370004 |
Anthem EPO 300/10%/3200 Platinum INN Blue Access Dep 25 Wellness Pediatric Dental DP C Opt Out RE A Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370008 |
Anthem EPO 300/10%/3200 Platinum INN Blue Access Dep 25 Wellness Pediatric Dental DP FP |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370016 |
Anthem EPO 300/10%/3200 Platinum INN Blue Access Dep 25 Wellness Pediatric Dental DP FP |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370015 |
Anthem EPO 300/10%/3200 Platinum INN Blue Access Dep 25 Wellness Pediatric Dental DP FP RE A Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370007 |
Anthem EPO 300/10%/3200 Platinum INN Blue Access Dep 25 Wellness Pediatric Dental DP FP RE A Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370010 |
Anthem EPO 300/10%/3200 Platinum INN Blue Access Dep 29 Wellness Pediatric Dental DP C Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370002 |
Anthem EPO 300/10%/3200 Platinum INN Blue Access Dep 29 Wellness Pediatric Dental DP C Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370003 |
Anthem EPO 300/10%/3200 Platinum INN Blue Access Dep 29 Wellness Pediatric Dental DP C Opt Out RE A Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370011 |
Anthem EPO 300/10%/3200 Platinum INN Blue Access Dep 29 Wellness Pediatric Dental DP C Opt Out RE A Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370013 |
Anthem EPO 300/10%/3200 Platinum INN Blue Access Dep 29 Wellness Pediatric Dental DP FP |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370005 |
Anthem EPO 300/10%/3200 Platinum INN Blue Access Dep 29 Wellness Pediatric Dental DP FP |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370014 |
Anthem EPO 300/10%/3200 Platinum INN Blue Access Dep 29 Wellness Pediatric Dental DP FP RE A Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370006 |
Anthem EPO 300/10%/3200 Platinum INN Blue Access Dep 29 Wellness Pediatric Dental DP FP RE A Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370049 |
Anthem EPO 3250/50%/9450 Silver INN Connection Dep 25 Wellness Pediatric Dental DP C Opt Out |
2024 |
NYN005
|
Feb 12, 2024 |
| 44113NY0370052 |
Anthem EPO 3250/50%/9450 Silver INN Connection Dep 25 Wellness Pediatric Dental DP C Opt Out RE A Opt Out |
2024 |
NYN005
|
Feb 12, 2024 |
| 44113NY0370056 |
Anthem EPO 3250/50%/9450 Silver INN Connection Dep 25 Wellness Pediatric Dental DP FP |
2024 |
NYN005
|
Feb 12, 2024 |
| 44113NY0370055 |
Anthem EPO 3250/50%/9450 Silver INN Connection Dep 25 Wellness Pediatric Dental DP FP RE A Opt Out |
2024 |
NYN005
|
Feb 12, 2024 |
| 44113NY0370050 |
Anthem EPO 3250/50%/9450 Silver INN Connection Dep 29 Wellness Pediatric Dental DP C Opt Out |
2024 |
NYN005
|
Feb 12, 2024 |
| 44113NY0370051 |
Anthem EPO 3250/50%/9450 Silver INN Connection Dep 29 Wellness Pediatric Dental DP C Opt Out RE A Opt Out |
2024 |
NYN005
|
Feb 12, 2024 |
| 44113NY0370053 |
Anthem EPO 3250/50%/9450 Silver INN Connection Dep 29 Wellness Pediatric Dental DP FP |
2024 |
NYN005
|
Feb 12, 2024 |
| 44113NY0370054 |
Anthem EPO 3250/50%/9450 Silver INN Connection Dep 29 Wellness Pediatric Dental DP FP RE A Opt Out |
2024 |
NYN005
|
Feb 12, 2024 |
| 44113NY0370041 |
Anthem EPO 4550/50%/9450 Silver INN Blue Access Dep 25 Wellness Pediatric Dental DP C Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370033 |
Anthem EPO 4550/50%/9450 Silver INN Blue Access Dep 25 Wellness Pediatric Dental DP C Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370044 |
Anthem EPO 4550/50%/9450 Silver INN Blue Access Dep 25 Wellness Pediatric Dental DP C Opt Out RE A Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370036 |
Anthem EPO 4550/50%/9450 Silver INN Blue Access Dep 25 Wellness Pediatric Dental DP C Opt Out RE A Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370048 |
Anthem EPO 4550/50%/9450 Silver INN Blue Access Dep 25 Wellness Pediatric Dental DP FP |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370040 |
Anthem EPO 4550/50%/9450 Silver INN Blue Access Dep 25 Wellness Pediatric Dental DP FP |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370039 |
Anthem EPO 4550/50%/9450 Silver INN Blue Access Dep 25 Wellness Pediatric Dental DP FP RE A Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370047 |
Anthem EPO 4550/50%/9450 Silver INN Blue Access Dep 25 Wellness Pediatric Dental DP FP RE A Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370034 |
Anthem EPO 4550/50%/9450 Silver INN Blue Access Dep 29 Wellness Pediatric Dental DP C Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370042 |
Anthem EPO 4550/50%/9450 Silver INN Blue Access Dep 29 Wellness Pediatric Dental DP C Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370043 |
Anthem EPO 4550/50%/9450 Silver INN Blue Access Dep 29 Wellness Pediatric Dental DP C Opt Out RE A Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370035 |
Anthem EPO 4550/50%/9450 Silver INN Blue Access Dep 29 Wellness Pediatric Dental DP C Opt Out RE A Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370045 |
Anthem EPO 4550/50%/9450 Silver INN Blue Access Dep 29 Wellness Pediatric Dental DP FP |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370037 |
Anthem EPO 4550/50%/9450 Silver INN Blue Access Dep 29 Wellness Pediatric Dental DP FP |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370038 |
Anthem EPO 4550/50%/9450 Silver INN Blue Access Dep 29 Wellness Pediatric Dental DP FP RE A Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370046 |
Anthem EPO 4550/50%/9450 Silver INN Blue Access Dep 29 Wellness Pediatric Dental DP FP RE A Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370081 |
Anthem EPO 8450/50%/9100 Bronze INN Blue Access Dep 25 Wellness Pediatric Dental DP C Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370089 |
Anthem EPO 8450/50%/9100 Bronze INN Blue Access Dep 25 Wellness Pediatric Dental DP C Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370084 |
Anthem EPO 8450/50%/9100 Bronze INN Blue Access Dep 25 Wellness Pediatric Dental DP C Opt Out RE A Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370092 |
Anthem EPO 8450/50%/9100 Bronze INN Blue Access Dep 25 Wellness Pediatric Dental DP C Opt Out RE A Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370096 |
Anthem EPO 8450/50%/9100 Bronze INN Blue Access Dep 25 Wellness Pediatric Dental DP FP |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370088 |
Anthem EPO 8450/50%/9100 Bronze INN Blue Access Dep 25 Wellness Pediatric Dental DP FP |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370095 |
Anthem EPO 8450/50%/9100 Bronze INN Blue Access Dep 25 Wellness Pediatric Dental DP FP RE A Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370087 |
Anthem EPO 8450/50%/9100 Bronze INN Blue Access Dep 25 Wellness Pediatric Dental DP FP RE A Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370090 |
Anthem EPO 8450/50%/9100 Bronze INN Blue Access Dep 29 Wellness Pediatric Dental DP C Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370082 |
Anthem EPO 8450/50%/9100 Bronze INN Blue Access Dep 29 Wellness Pediatric Dental DP C Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370091 |
Anthem EPO 8450/50%/9100 Bronze INN Blue Access Dep 29 Wellness Pediatric Dental DP C Opt Out RE A Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370083 |
Anthem EPO 8450/50%/9100 Bronze INN Blue Access Dep 29 Wellness Pediatric Dental DP C Opt Out RE A Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370093 |
Anthem EPO 8450/50%/9100 Bronze INN Blue Access Dep 29 Wellness Pediatric Dental DP FP |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370085 |
Anthem EPO 8450/50%/9100 Bronze INN Blue Access Dep 29 Wellness Pediatric Dental DP FP |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370094 |
Anthem EPO 8450/50%/9100 Bronze INN Blue Access Dep 29 Wellness Pediatric Dental DP FP RE A Opt Out |
2024 |
NYN010
|
Feb 12, 2024 |
| 44113NY0370086 |
Anthem EPO 8450/50%/9100 Bronze INN Blue Access Dep 29 Wellness Pediatric Dental DP FP RE A Opt Out |
2024 |
NYN004
|
Feb 12, 2024 |
| 44113NY0370073 |
Anthem EPO 8450/50%/9100 Bronze INN Connection Dep 25 Wellness Pediatric Dental DP C Opt Out |
2024 |
NYN005
|
Feb 12, 2024 |
| 44113NY0370076 |
Anthem EPO 8450/50%/9100 Bronze INN Connection Dep 25 Wellness Pediatric Dental DP C Opt Out RE A Opt Out |
2024 |
NYN005
|
Feb 12, 2024 |
| 44113NY0370080 |
Anthem EPO 8450/50%/9100 Bronze INN Connection Dep 25 Wellness Pediatric Dental DP FP |
2024 |
NYN005
|
Feb 12, 2024 |
| 44113NY0370079 |
Anthem EPO 8450/50%/9100 Bronze INN Connection Dep 25 Wellness Pediatric Dental DP FP RE A Opt Out |
2024 |
NYN005
|
Feb 12, 2024 |
| 44113NY0370074 |
Anthem EPO 8450/50%/9100 Bronze INN Connection Dep 29 Wellness Pediatric Dental DP C Opt Out |
2024 |
NYN005
|
Feb 12, 2024 |
| 44113NY0370075 |
Anthem EPO 8450/50%/9100 Bronze INN Connection Dep 29 Wellness Pediatric Dental DP C Opt Out RE A Opt Out |
2024 |
NYN005
|
Feb 12, 2024 |
| 44113NY0370077 |
Anthem EPO 8450/50%/9100 Bronze INN Connection Dep 29 Wellness Pediatric Dental DP FP |
2024 |
NYN005
|
Feb 12, 2024 |
| 44113NY0370078 |
Anthem EPO 8450/50%/9100 Bronze INN Connection Dep 29 Wellness Pediatric Dental DP FP RE A Opt Out |
2024 |
NYN005
|
Feb 12, 2024 |
