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Medical Claim Summary

Patient:   Status:    
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Click the More Details link for a claim to see the Explanation of Benefits (EOB) statement and get more information about the claim.

Claim Summary  
(Showing 1-5 of 26)   Display all Results at Once | Next 10 >
Patient Details Status Billed Amount Applied to
Deductible 		Paid by Plan Patient
Responsibility 		Already
Paid
Chris
Johnson

Date of Service:
1/17/08
Labcorp
Medical

More Details

Processed
1/27/08		 $247.00 $0.00 $84.35 $0.00  
Pat
Johnson		 Date of Service: 4/12/08
Scott Murray
Medical

More Details
Processed
4/22/08		 $362.10
$0.00
 $211.50 $150.60
Paid by HRA  
$16.40
Paid by FSA  
$114.20
Madison 
Johnson		 Date of Service: 04/04/08
Julien Osborne
Medical

More Details
Processed
4/24/08		 $193.00
$0.00
 $0.00 $96.01
Paid by HRA
$96.01
Madison
Johnson

Date of Service: 02/01/08
Julien Osborne
Medical

More Details

Processed
2/11/08		 $175.00
$0.00
 $0.00 $53.99
Paid by HRA
$53.99
Pat 
Johnson

Date of Service: 1/17/08
Scott Murray
Medical

More Details

Processed
1/27/08		 $500.00
$0.00
 $25.00 $283.60
Paid by HRA
$283.60
Totals for all
claims in results 		$1,477.10 $450 $320.85 $584.20 *$564.20
(Showing 1-5 of 26)   Display all Results at Once | Next 10 >
* Does not reflect dollars paid at the time of visit, such as copayments or coinsurance.
     
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Common Questions more
 
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Today's Date: Jun 5, 2008©2008 UnitedHealthcare