1 results for "1513341763"
Page 1 of 1
EFTA00311382.pdf
...STD•EOB
Use this EOB statement as a reference or retain as needed
Page 4 of 7
00[000704073311
EFTA00311391
BALIC0109311X0554A0.1513341763.AFJ 1734
MitedHealthcare Insurance Company
3REENSBORO SMALL GROUP
O BOX 740800
Thone:
VILANSS30
-0800
UnitedHeakhcare
PUN!~ &ROCS/
May 13. 2015
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John Smith