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Pat Smith
City Primary Care
10/16/24You Owe: $256.35 -
Julia Smith
City Primary Care
10/19/24You Owe: $256.35 -
Jane Smith
Jeffersonville Pediatrics: Wellness Visit
10/20/24You Owe: $200.00 -
Jane Smith
Central Diagnostics (NR)
10/23/24You Owe: $120.00 -
Jane Smith
Jeffersonville Pediatrics: FUP Stomach Pain
10/24/24You Owe: $0.00 -
Jane Smith
Children’s Hospital: Initial visit with GI physician
10/25/24You Owe: $350.00 -
Jane Smith
Children’s Hospital: Colonoscopy
10/27/24You Owe: $3,500.00 -
Jane Smith
Valley Health Anesthesiologists (NR)
10/28/24You Owe: $1,400.00 -
Jane Smith
Children’s Hospital – GI
10/30/24You Owe: $6,000.00
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Pat Smith
Vision Plan (Incontext)
View StatementBalance:
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Pat Smith
Dental Plan (Embedded)
View StatementBalance:
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Pat Smith
Medical Plan
View StatementBalance:
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Employer Group (10 Members)
Vision Plan (Incontext)
View StatementBalance: $150.00
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Employer Group (10 Members)
Medical Plan (New Tab)
View StatementBalance: $2,500.00
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Employer Group (10 Members)
Dental Plan (Embedded)
View StatementBalance: $500.00
Name | Plan | Balance |
---|---|---|
Pat Smith | Medical HDHP | $300.00 |
Pat Smith | Vision Plan | $45.00 |
Pat Smith | Dental DHMO | $45.00 |
Total | $390.00 |
Plan | Total Members | Total |
---|---|---|
Division 1 - Medical PPO | 10 | $3,000.00 |
Divison 2 - Medical HDHP | 10 | $3,000.00 |
Divison 1 - Dental Plan | 10 | $450.00 |
Divison 2 - Dental Plan | 10 | $450.00 |
Divison 1 - Vision Plan | 10 | $450.00 |
Divison 2 - Vision Plan | 10 | $450.00 |
Total | $7,800.00 |