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  • The maximum dollar amount allowed for covered services rendered by participating providers and facilities or by nonparticipating providers and facilities.
  • Deductibles and coinsurance amounts are calculated from eligible charges.
  • Participating providers and facilities accept this allowed amount as payment in full for covered services.
  • Nonparticipating providers and facilities may not accept this amount as payment in full for covered services.
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Q: What is meant by allowed amount?
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