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Payment Request
PAYEE HEALTH CARE SERVICE CORPORATION
EXPENSE CATEGORY SERVICES-BENEFITS MANAGEMENT
DEPARTMENT HUMAN RESOURCES
FUND EMPLOYEE BENEFITS FUND
PROGRAM EMPLOYEE DENTAL
ACTIVITY EMPLOYEE DENTAL
PAYMENT REQUEST PRM 5800 22011409596
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PURCHASE ORDER CONTRACT DESCRIPTION REF. LINE CHECK DATE CHECK STATUS  AMOUNT
DO 5800 22011103991 n/a INSURANCE, ALL TYPES 111 01/18/2022 Paid $24,521.40