EFTA00304634.pdf

BOUTHg_RN TRUST 0QMPANY 6100 REO HOOK QUARTER, B-3 s-r THOMAS VI 00802-0000 UnitedHealthcare . -s 4 >002669 7080107 003082 J.EPSTEIN 6100 RED HOOK QUARTER B-3 ST THOMAS VI 00802-0000 03082 7080107 0000 0002869 3519 116 EFTA00304634 / girt 4å. t tie; fig : 11'4 .iii Ill 1 iii2 911 s ill ill! la: tot i 1. /I 23 1 it 1! i ; 4ggic7 e b§:1,3 12c§ Ilå4 i! 1 g!ii: RISE il : ;315; s li7si i hf 1 , 3i 3 f; I lirti Ipi 11 % g-ill, !pi; - it >5kg: X 80,1 0 red Nat dims Members: We're here to Check benefits, view claims. flod a dodor, ask a eue -00n anted more. Web: www.myuhc&Om CS ~inn n seem Email: Advocatedmetauhc.com eilh a Nurse Phone: 800-782.3740 Mont,* Hpallh: 800.8424085 Providers: 877-842-3210 orrenv.UnindHeallhcem0nleccore Medical Claims: P.O. B0%710800 ATLANTAGA 300701903 PR • stsPPRE - PO Boxie2s7. San Juan, PR M36-8297 . 2 U a m& •40Multinan .MA/FRE '-41'.`•.^44 Pearmactsts: 88B490-S416 Pharmacy Claims: 0akum% PO Box 29044 Hal Sprint, AR 71903 002649 0000000 7000101 003003 002.70 01/01 EFTA00304635