How Your Plan Savings Was Calculated

Claim Number 2016315CJ3254

Received Nov. 10, 2016

Patient David (02/15/1988)

Service From Dr Margie Smith And Assoc

Allowed Amount$40.00The amount the doctor or health care facility has agreed to accept as a negotiated payment. This is the amount used to determine how much you will owe.

Amount Plan Paid$32.00The amount your plan paid to the doctor to cover the care you received as a part of this claim.

Total Plan Savings$32.00

 

How Your Plan Savings Was Calculated

Claim Number 2016294CJ2614

Received Oct. 20, 2016

Patient David (02/15/1988)

Service From Dr Margie Smith And Assoc

Allowed Amount$40.00The amount the doctor or health care facility has agreed to accept as a negotiated payment. This is the amount used to determine how much you will owe.

Amount Plan Paid$28.00The amount your plan paid to the doctor to cover the care you received as a part of this claim.

Total Plan Savings$28.00

 

How Your Plan Savings Was Calculated

Claim Number 2016309CK2060

Received Nov. 04, 2016

Patient David (02/15/1988)

Service From Dr Margie Smith And Assoc

Allowed Amount$40.00The amount the doctor or health care facility has agreed to accept as a negotiated payment. This is the amount used to determine how much you will owe.

Amount Plan Paid$32.00The amount your plan paid to the doctor to cover the care you received as a part of this claim.

Total Plan Savings$32.00

 

How Your Plan Savings Was Calculated

Claim Number 2016309CK2059

Received Nov. 04, 2016

Patient David (02/15/1988)

Service From Dr Margie Smith And Assoc

Allowed Amount$40.00The amount the doctor or health care facility has agreed to accept as a negotiated payment. This is the amount used to determine how much you will owe.

Amount Plan Paid$32.00The amount your plan paid to the doctor to cover the care you received as a part of this claim.

Total Plan Savings$32.00

 

How Your Plan Savings Was Calculated

Claim Number 2016315CJ3249

Received Nov. 10, 2016

Patient David (02/15/1988)

Service From Dr Margie Smith And Assoc

Allowed Amount$40.00The amount the doctor or health care facility has agreed to accept as a negotiated payment. This is the amount used to determine how much you will owe.

Amount Plan Paid$32.00The amount your plan paid to the doctor to cover the care you received as a part of this claim.

Total Plan Savings$32.00

 

How Your Plan Savings Was Calculated

Claim Number 2016322CN5329

Received Nov. 17, 2016

Patient David (02/15/1988)

Service From Dr Margie Smith And Assoc

Allowed Amount$40.00The amount the doctor or health care facility has agreed to accept as a negotiated payment. This is the amount used to determine how much you will owe.

Amount Plan Paid$32.00The amount your plan paid to the doctor to cover the care you received as a part of this claim.

Total Plan Savings$32.00

 

How Your Plan Savings Was Calculated

Claim Number 2016322CN5323

Received Nov. 17, 2016

Patient David (02/15/1988)

Service From Dr Margie Smith And Assoc

Allowed Amount$40.00The amount the doctor or health care facility has agreed to accept as a negotiated payment. This is the amount used to determine how much you will owe.

Amount Plan Paid$32.00The amount your plan paid to the doctor to cover the care you received as a part of this claim.

Total Plan Savings$32.00

 

 

Medical Claim Number 2016305CM2362

Received Oct. 31, 2016

Since this claim is still pending, details and costs for this claim are not yet available. Typical processing time is 30 days.

 

Medical Claim Number 2016305CM2360

Received Oct. 31, 2016

Since this claim is still pending, details and costs for this claim are not yet available. Typical processing time is 30 days.