DO 5800 13121104790 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
118 |
12/18/2013 |
Paid |
$11,298.25 |
DO 5800 13121104790 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
1111 |
12/18/2013 |
Paid |
$6,095.80 |
DO 5800 13121104790 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
1112 |
12/18/2013 |
Paid |
$8,933.50 |
DO 5800 13121104790 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
114 |
12/18/2013 |
Paid |
$34,472.80 |
DO 5800 13121104790 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
112 |
12/18/2013 |
Paid |
$85,309.67 |
DO 5800 13121104790 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
117 |
12/18/2013 |
Paid |
$16,595.29 |