DO 5800 15071316894 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
112 |
07/20/2015 |
Paid |
$150,835.68 |
DO 5800 15071316894 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
115 |
07/20/2015 |
Paid |
$31,133.28 |
DO 5800 15071316894 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
1114 |
07/20/2015 |
Paid |
$5,807.52 |
DO 5800 15071316894 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
1118 |
07/20/2015 |
Paid |
$71.04 |
DO 5800 15071316894 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
1111 |
07/20/2015 |
Paid |
$10,123.20 |
DO 5800 15071316894 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
1112 |
07/20/2015 |
Paid |
$15,326.88 |
DO 5800 15071316894 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
118 |
07/20/2015 |
Paid |
$53,777.28 |
DO 5800 15071316894 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
116 |
07/20/2015 |
Paid |
$23,443.20 |
DO 5800 15071316894 |
n/a
|
Health/Hospitalization (Including Dental and Vision) |
1117 |
07/20/2015 |
Paid |
$213.12 |