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Claims & Accounts Account Balances Medical Claim Summary Health Reimbursement Account Health Savings Account   Flexible Spending Account(s) View Statements Other Claims Prescription Claims Dental Claims Vision Claims Mental Health Claims Member Actions Submit a Claim Appeal a Claim Automatic Payment Options Mailing Preferences Direct Deposit Coordination of Benefits Request ID Cards Flexible Spending Account (FSA) Claim Detail Back to FSA Summary Date(s) of Service: 1/01/06 – 3/31/06 Status: Awaiting Funds Claim Number: 205MR039900 Date Received: 4/12/06 Download Explanation of Benefits(EOB)    FSA Claim Detail Date(s) of Service Expense Type Remark Code Submitted Amount Paid Amount Pending Amount 01/01/06 – 01/31/06 Dependent Care   $345.00 $345.00 $0.00 02/01/06 – 02/28/06 Dependent Care *R2 $345.00 $112.00 $233.00 03/01/06 – 03/31/06 Dependent Care *L2 $345.00 $0.00 $345.00 Claim Notes *Remark Code R2: Amount submitted exceeds account balance. *Remark Code L2: Amount submitted exceeds annual election. Claim History Date Activity 1/01/06 – 3/31/06 Date(s) of service 4/12/06 Claim received 4/14/06 Claim processed 4/15/06 Payment #216244 sent to member for $457.00