| Code | Display | Definition |
| FamOutDed |
Family Out of Network Deductible |
Family Out of Network Deductible |
| FamInDed |
Family In Network Deductible |
Family In Network Deductible |
| FamRxOutDed |
Family Pharmacy Out of Network Deductible |
Family Pharmacy Out of Network Deductible |
| FamRxInDed |
Family Pharmacy In Network Deductible |
Family Pharmacy In Network Deductible |
| FamOutMax |
Family Out of Network Out of Pocket Maximum |
Family Out of Network Out of Pocket Maximum |
| FamInMax |
Family In Network Out of Pocket Maximum |
Family In Network Out of Pocket Maximum |
| FamRxOutMax |
Family Pharmacy Out of Network Out of Pocket Maximum |
Family Pharmacy Out of Network Out of Pocket Maximum |
| FamRxInMax |
Family Pharmacy In Network Out of Pocket Maximum |
Family Pharmacy In Network Out of Pocket Maximum |
| IndOutDed |
Invidual Out of Network Deductible |
Individual Out of Network Deductible |
| IndInDed |
Individual In Network Deductible |
Individual In Network Deductible |
| IndRxOutDed |
Individual Pharmacy Out of Network Deductible |
Individual Pharmacy Out of Network Deductible |
| IndRxInDed |
Individual Pharmacy In Network Deductible |
Individual Pharmacy In Network Deductible |
| IndOutMax |
Individual Out of Network Out of Pocket Maximum |
Individual Out of Network Out of Pocket Maximum |
| IndInMax |
Individual In Network Out of Pocket Maximum |
Individual In Network Out of Pocket Maximum |
| IndRxOutMax |
Individual Pharmacy Out of Network Out of Pocket Maximum |
Individual Pharmacy Out of Network Out of Pocket Maximum |
| IndRxInMax |
Individual Pharmacy In Network Out of Pocket Maximum |
Individual Pharmacy In Network Out of Pocket Maximum |
| rx |
Prescription |
Prescription |