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Choice PPO (high)
Single
$24.00/mo
Single + Spouse
$45.00/mo
Single + Child(ren)
$74.00/mo
Family
$100.00/mo

Ortho
Benefits
Office Co-Pay: $25
Plan Deductible: $25/$75
Annual Maximum: $1000
Preventive
Basic
Major
Waiting
None
6 months
18 months
Plan Pays
100%
80% in-network
70% out-network
50% in-network
50% out-network
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