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Field Descriptions for the Consolidated Family Statement - Medical 1 – [Mailing address]. Name and mailing address for the member. 19 –Plan Pays. The amount your plan will pay for this service in absence of any adjus
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Document Date: 2012-05-01 10:36:10
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File Size: 66,65 KB
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City
Member /
Form /
Claim /
/
Company
Aetna /
/
ProvinceOrState
Virginia /
/
SocialTag
Aetna
Medical billing
Insurance
Copayment
Co-insurance