 |
| Patient |
|
Details |
|
Status  |
|
Billed Amount |
|
Applied to
Deductible |
|
Paid by Plan |
|
Patient
Responsibility |
|
Already
Paid |
|
Chris
Johnson |
Date of Service:
1/17/06
Labcorp
Medical
|
Processed
1/27/06 |
$247.00 |
|
$84.35 |
$0.00 |
|
Pat
Johnson |
Date of Service: 4/12/06
Scott Murray
Medical
|
Processed
4/22/06 |
$362.10 |
|
$211.50 |
$150.60 |
| Paid by HRA |
|
$16.40 |
| Paid by FSA |
|
$114.20 |
|
Madison
Johnson |
Date of Service: 04/04/06
Julien Osborne
Medical
|
Processed
4/24/06 |
$193.00 |
| Madison |
$96.01 |
| Family |
$96.01 |
|
$0.00 |
$96.01 |
|
Madison
Johnson |
Date of Service: 02/01/06
Julien Osborne
Medical
|
Processed
2/11/06 |
$175.00 |
| Madison |
$53.99 |
| Family |
$53.99 |
|
$0.00 |
$53.99 |
|
Pat
Johnson |
Date of Service: 1/17/06
Scott Murray
Medical
|
Processed
1/27/06 |
$500.00 |
| Pat |
$283.60 |
| Family |
$283.60 |
|
$25.00 |
$283.60 |
|
|
|
Totals for all
claims in results |
$1,477.10 |
| Chris |
|
$0.00 |
| Madison |
|
$150.00 |
| Pat |
|
$300.00 |
| Family |
|
$450.00 |
|
$320.85 |
$584.20 |
$564.20 |
|
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