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Table Components

Claim Description

Date

Cost

Status

Dentist icon

Dentist Visit at Taylor Dental

12/30/2019

Paid

12/30/2019

$1526,00

Paid

Medical icon

Provider visit at Intermountain Medical. Provider visit at Intermountain Medical.

1/17/2020

Pending

1/17/2020

$1256,00

Pending

Optical icon

Provider visit to Standard Optical

3/24/2019

Paid

3/24/2019

$89,00

Paid

Medical icon

Provider visit at Intermountain Medical

7/12/201

Denied

7/12/201

$96,00

Denied

Medical icon

Provider visit at Urgent Care, Riverton

7/12/2019

Pending

7/12/2019

$96,00

Pending

Paid

Denied

Pending

Pagination

Claim Description

Date

NUMBER ID

Cost

Status

Dentist icon

Dentist Visit at Taylor Dental

12/30/2019

Paid

12/30/2019

219-0001612518-00

$1526,00

Appeal

Paid

Dependent

Coverage

Status

User avatar

Jane Doe

Spouse

Active

Badges

Medical Medical
Pharmacy Pharmacy
Dental Dental
Vision Vision
We’re Hiring!

Cards

TeleHealth

TeleMedicine icon

TeleMedicine and WellVia

Talk with a doctor at your
convenience for free.

Cost Transparency

Calculator icon

Smart Cost Calculator

Know the cost of doctors, facilities,
and procedures before you visit
the doctor.

Mental Health

Initiative icon

The Care Initiative

It’s time we address mental health.
Blunovus is here for you.

Care Management

Management icon

Care Management

Your wellness program lives here with
support for every phase of your
healthcare journey.

Welcome to Your Dashboard

1232 - 4567 - 8901

Member ID

Medical

Care Plus
PHD5000

Pharmacy

Rx BIN 610014 GRP: EMIARXD

Dental

Choice PPO

Vision

VSP 10-130

Member Avatar

John Doe

Birthday:

01 / 01 /1980

Gender:

Male

Phone:

801-808-8049

Address:

Herriman, Utah 84070,
13654 S 6548 W, Apt. 239

Recent Claims

Total Sum:

$0,00


Total:

Medical transactions
Dental transactions
Vision transactions
Pharmacy transactions

Total Budget Status:

$0,00


Total:

Medical transactions
Dental transactions
Vision transactions
Pharmacy transactions

Accumulators

Out-of-Pocket Max
$0,00 Your Contributions
Deductible


Paid:

N/A

Out-of-Pocket Max

N/A

Total Paid by You

$4,272.00

Accumulators

Out-of-Pocket Max
$0,00 Your Contributions
Deductible


Paid:

N/A

Out-of-Pocket Max

N/A

Total Paid by You

$4,272.00

Accumulators

Out-of-Pocket Max
$0,00 Your Contributions
Deductible


Paid:

N/A

Out-of-Pocket Max

N/A

Total Paid by You

$4,272.00

Accumulators

Annual Maximum
In-Network

Does not apply

N/A

Out-Of-Network

N/A

Major Services

N/A

Orthodontic Lifetime Maximum

N/A

Deductibles

In-Network
Individual

N/A

Family

N/A

Total Paid by You

$4,272.00

Accumulators

Annual Maximum
In-Network

Does not apply

$2,000

Out-Of-Network

N/A

Major Services

N/A

Orthodontic Lifetime Maximum

$5000

Deductibles

In-Network
Individual

$48

Family

$25

Total Paid by You

$4,272.00

Accumulators

Annual Maximum
In-Network

Does not apply

N/A

Out-Of-Network

$2,000

Major Services

N/A

Orthodontic Lifetime Maximum

N/A

Deductibles

Out-Of-Network
Individual

$48

Family

$25

Total Paid by You

$4,272.00

Accumulators

Annual Maximum
In-Network

Does not apply

N/A

Out-Of-Network

N/A

Major Services

N/A

Orthodontic Lifetime Maximum

N/A

Deductibles

In-Network
Individual

$48

Family

$25

Total Paid by You

$4,272.00

Claim Description

Date

Cost

Status

Dentist icon

Dentist Visit at Taylor Dental

12/30/2019

Paid

12/30/2019

$1526,00

Paid

Medical icon

Provider visit at Intermountain Medical. Provider visit at Intermountain Medical.

1/17/2020

Pending

1/17/2020

$1256,00

Pending

Optical icon

Provider visit to Standard Optical

3/24/2019

Paid

3/24/2019

$89,00

Paid

Medical icon

Provider visit at Intermountain Medical

7/12/201

Denied

7/12/201

$96,00

Denied

Medical icon

Provider visit at Urgent Care, Riverton

7/12/2019

Pending

7/12/2019

$96,00

Pending

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