$8,150
$-1,000
$7,150
-126
11/12: Balance = $7,024 ($501.71 per pay period 11/12 -5/31/21)

Request Health Plan Activity Payment

ID
ERFCMYZ4800 Aetna Traditional
Date
10/05/2020
Patient Name
NATHAN
Provider
75 Lindall St Opco, Llc
Plan Paid
$0.00
Patient Amount Due
$6,450.57
Amount Remaining
$6,450.57

11/12: -$305.10

HR:  800-238-6247