DO 5800 11041414664 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
112 |
04/27/2011 |
Paid |
$31,299.64 |
DO 5800 11041414664 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
114 |
04/27/2011 |
Paid |
$15,556.56 |
DO 5800 11041414664 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
111 |
04/27/2011 |
Paid |
$29,664.12 |
DO 5800 11041414664 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
113 |
04/27/2011 |
Paid |
$1,310.52 |
DO 5800 11041414666 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
122 |
04/27/2011 |
Paid |
$275.48 |
DO 5800 11041414666 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
124 |
04/27/2011 |
Paid |
$68.04 |
DO 5800 11041414666 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
123 |
04/27/2011 |
Paid |
$742.05 |
DO 5800 11041414666 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
121 |
04/27/2011 |
Paid |
$192.00 |