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¥ 1.0
• Certified Registered Nurse Practitioner Services • Chiropractic Services • Clinic Services • Crisis Services • Contact Lenses (Limited to individuals with aphakia) • Dental Care Services • Durable Medical Equipment • Emergency Room/Ambulance Services • Eyeglass Frames (Limited to individuals with aphakia) • Eyeglass Lenses (Limited to individuals with aphakia) • Family Planning Services and Supplies • Federally Qualified Health Center Services/Rural Health Clinic Services • Home Health Services • Hospice Services • ICF/IID and ICF/ORC (Requires an institutional level of care) • Inpatient Drug & Alcohol Services • Inpatient Hospital Services • Inpatient Mental Health Services • Laboratory Services • Maternity - Physician, Certified Nurse, Midwives, Birth Centers • Medical Supplies • Methadone Maintenance • Mobile Mental Health Treatment • Non-Emergency Medical Transportation (only to and from covered services) • Nursing Facility Services
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