DO 5800 13101101234 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
1111 |
10/22/2013 |
Paid |
$6,158.86 |
DO 5800 13101101234 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
117 |
10/22/2013 |
Paid |
$16,584.78 |
DO 5800 13101101234 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
114 |
10/22/2013 |
Paid |
$34,525.35 |
DO 5800 13101101234 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
1112 |
10/22/2013 |
Paid |
$8,859.93 |
DO 5800 13101101234 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
118 |
10/22/2013 |
Paid |
$11,109.07 |
DO 5800 13101101234 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
112 |
10/22/2013 |
Paid |
$84,647.54 |