DHMO/Direct Compensation Member Copayment Schedules

DHMO/Direct Compensation Member Copayment Schedules

DHMO / DC Member Copayment Schedules

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DHMO/Direct Compensation Member Copayment Schedules

UHC CA DHMO Plans

Blue Shield of CA DHMO Plans

Health Net of CA DHMO Plans

UHC CA Direct Compensation Plans

UHC-NPD NV Direct Compensation Plans

Blue Shield of CA Family Dental plan DHMO

UHC CA AARP DHMO

UHC TX DHMO Plans

D0032064 (Elderplan Extra Help 009)

D0032089 (UHC Healthplex ASO Custom NY Only Plan 71P40)

D0032091 (UHC Healthplex ASO Custom NY Only Plan 72P03)

D0032092 (UHC Healthplex ASO Custom NY Only Plan 72P04)

D0032093 (UHC Healthplex ASO Custom NY Only Plan 72P05)

D0032094 (UHC Healthplex ASO Custom NY Only Plan 72P06)

D0032095 (UHC Healthplex ASO Custom NY Only Plan 72P07)

D0032096 (UHC Healthplex ASO Custom NY Only Plan 71P98)

D0032097 (UHC Healthplex ASO Custom NY Only Plan 71P97)

D0032098 (UHC Healthplex ASO Custom NY Only Plan 71P99)

D0032099 (UHC Healthplex ASO Custom NY Only Plan 72P01)

D0032600 (UHC Healthplex ASO Custom NY Only Plan 72P02)

D0032601 (UHC Healthplex ASO Custom NY Only Plan 71P14)

D0032602 (UHC Healthplex ASO Custom NY Only Plan 71P07)

D0032603 (UHC Healthplex ASO Custom NY Only Plan 71P08)

D0032605 (UHC Healthplex ASO Custom NY Only Plan 73P22)

D0032606 (UHC Healthplex ASO Custom NY Only Plan 73P18)

D0032607 (UHC Healthplex ASO Custom NY Only Plan 73P16)

D0032608 (UHC Healthplex ASO Custom NY Only Plan 73P17)

D0032609 (UHC Healthplex ASO Custom NY Only Plan 73P49)

D0032610 (UHC Healthplex ASO Custom NY Only Plan 73P19)

D0032611 (UHC Healthplex ASO Custom NY Only Plan 73P25)

D0032612 (UHC Healthplex ASO Custom NY Only Plan 73P26)

D0032613 (UHC Healthplex ASO Custom NY Only Plan 73P21)

D0032614 (UHC Healthplex ASO Custom NY Only Plan 73P59)

D0032615 (UHC Healthplex ASO Custom NY Only Plan 73P50)

D0032616 (UHC Healthplex ASO Custom NY Only Plan 73P66)

D0032617 (UHC Healthplex ASO Custom NY Only Plan 73P51)

D0032618 (UHC Healthplex ASO Custom NY Only Plan 73P52)

D0032619 (UHC Healthplex ASO Custom NY Only Plan 73P36)

D0032620 (UHC Healthplex ASO Custom NY Only Plan 73P37)

D0032621 (UHC Healthplex ASO Custom NY Only Plan 73P38)

D0032622 (UHC Healthplex ASO Custom NY Only Plan 73P39)

D0032623 (UHC Healthplex ASO Custom NY Only Plan 73P40)

D0032624 (UHC Healthplex ASO Custom NY Only Plan 73P42)

D0032625 (UHC Healthplex ASO Custom NY Only Plan 73P43)

D0032626 (UHC Healthplex ASO Custom NY Only Plan 73P44)

D0032627 (UHC Healthplex ASO Custom NY Only Plan 73P45)

D0032628 (UHC Healthplex ASO Custom NY Only Plan 73P46)

D0032629 (UHC Healthplex ASO Custom NY Only Plan 73P48)

D0032630 (Dentcare KA-TLC DHMO Plan 14186)

D0032631 (UHC Healthplex ASO Custom NY Only Plan 73P43S)

D0032632 (UHC Healthplex ASO Custom NY Only Plan 73P43C)

D0032633 (N.Y.S. Court Clerks Assoc. Plan 14120)

D0033165 (EmblemHealth VIP Gold (HMO))

D0033319 (Dentcare Standard DHMO Plan 14102)

D0033320 (Dentcare Standard DHMO Plan 14103)

D0033321 (Dentcare Standard DHMO Plan 14104)

D0033322 (Dentcare Standard DHMO Plan 14105)

D0033323 (Dentcare Standard DHMO Plan 14106)

D0033324 (Dentcare Standard DHMO Plan 14107)

D0033325 (Dentcare Standard DHMO Plan 14108)

D0033326 (Dentcare Standard DHMO Plan 14109)

D0033353 (UPSE Benefit Plan - T Plan 14037)

D0033373 (Uniformed Sanitationmen's Assn. Retiree Plan 14161)

D0033376 (MTA NYCTA - T.S.O. Career & Salary Plan 14158)

D0033382 (UFT Health Care Chapter Plan 14152)

D0033383 (UPSE Benefit Plan - J DHMO Plan 14151)

D0033388 (Local 1199 National Benefit Fund - Employees Plan 14148)

D0033390 (UPSE Benefit Plan - H DHMO Plan 14146)

D0033391 (UPSE Benefit Plan - M DHMO Plan 14145)

D0033392 (MTA NYCTA - MABSTOA Plan 14144)

D0033397 (ATU Local 1056 ATU - Retirees Plan 14140)

D0033398 (UPSE Benefit Plan - N DHMO Plan 14139)

D0034847 (UHC Healthplex ASO Custom NY Only Plan 73P54)

D0034848 (UHC Healthplex ASO Custom NY Only Plan 73P55)

D0034849 (UHC Healthplex ASO Custom NY Only Plan 73P56)

D0034850 (UHC Healthplex ASO Custom NY Only Plan 73P57)

D0034851 (UHC Healthplex ASO Custom NY Only Plan 72P76)

D0034852 (UHC Healthplex ASO Custom NY Only Plan 72P79)

D0034853 (UHC Healthplex ASO Custom NY Only Plan 72P80)

D0034854 (UHC Healthplex ASO Custom NY Only Plan 72P84)

D0034855 (UHC Healthplex ASO Custom NY Only Plan 72P87)

D0034856 (UHC Healthplex ASO Custom NY Only Plan 72P93)

D0034857 (UHC Healthplex ASO Custom NY Only Plan 72P97)

D0034858 (UHC Healthplex ASO Custom NY Only Plan 72P98)

D0034859 (UHC Healthplex ASO Custom NY Only Plan 73P00)

D0034860 (UHC Healthplex ASO Custom NY Only Plan 73P03)

D0034861 (UHC Healthplex ASO Custom NY Only Plan 74P85)

D0034900 (Local 1180 CWA Plan 14137)

D0034901 (Local 1180 Retirees CWA Plan 14136)

D0034902 (MTA NYCTA MGT, OA, TA, SIRTOA Plan 14135)

D0034905 (UPSE Benefit Plan - U Plan 14132)

D0034906 (MTA NYCTA NON-REP Employees Plan 14133)

D0034908 (UPSE Benefit Plan - F DHMO Plan 14130)

D0034918 (AFGE DHMO Plan 14126)

D0034920 (AFGE Local 2204 - Individual Plan 14165)

D0034921 (AFGE Local 524 Plan 14166)

D0034932 (YORK MG Union Plan 14125)

D0034935 (ATU Local 726 Retirees Plan 14122)

D0034936 (ATU Local 726 Benefits Trust Plan 14121)

D0034937 (N.Y.S. Court Clerks Assoc. Plan 14120)

D0034938 (YORK MG Non-Union Plan 14119)

D0036048 (International Union Of Operating Local 15 DHMO Plan 14171)

D0036052 (Nassau County Retired Union Members DHMO Plan 14183)

D0036057 (International Union Of Operating Local 14 DHMO Plan 14172)

D0036058 (Teamsters Local 522 Welfare Fund Plan 14173)

D0036059 (United Service Workers Plan 14174)

D0036060 (District Council 1707, Local 95 Plan 14168)

D0036063 (C.S.A. Retirees Plan 14180)

D0037310 (UHC Healthplex ASO Custom NY Only Plan 65P13)

D0037335 (UHC Healthplex ASO Custom NY Only Plan 71P94)HEALTHPLEX 4A

D0037335 (UHC Healthplex ASO Custom NY Only Plan 71P94)HEALTHPLEX 14C

D0037414 (UHC Healthplex ASO Custom NY Only Plan 67P24)

D0037415 (UHC Healthplex ASO Custom NY Only Plan 67P23)

D0037440 (UHC ASO Custom Plan 71P85 - Waiting Period)

D0037441 (UHC ASO Custom Plan 71P85 - No Waiting Period)

D0037442 (UHC Healthplex ASO Custom NY Only Plan 71P86 - Waiting Period)

D0037443 (UHC Healthplex ASO Custom NY Only Plan 71P86 - No Waiting Period)

D0037620 (UHC Healthplex ASO Custom NY Only Plan 72P25)

D0037621 (UHC Healthplex ASO Custom NY Only Plan 71P33)

D0037643 (EmblemHealth VIP Gold Plus (HMO))

D0037644 (EmblemHealth VIP Rx Saver (HMO))

The current DHMO and Direct Compensation fee schedules are now available online for your reference.

If you are interested in participating in these programs, please request information on becoming a contracted provider at Join our Network or call 1-800-822-5353.