DO 5800 13101101234 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
111 |
10/22/2013 |
Paid |
$262,560.40 |
DO 5800 13101101234 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
113 |
10/22/2013 |
Paid |
$107,091.00 |
DO 5800 13101101234 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
119 |
10/22/2013 |
Paid |
$19,103.60 |
DO 5800 13101101234 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
115 |
10/22/2013 |
Paid |
$51,442.80 |
DO 5800 13101101234 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
1110 |
10/22/2013 |
Paid |
$27,481.80 |
DO 5800 13101101234 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
116 |
10/22/2013 |
Paid |
$34,458.20 |