Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)

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ST2

EJEMPLOS DE ESTADOS DE CUENTA TRICARE

Ejemplo 1: Beneficios de Administradores del Gobierno de Palmetto

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d Amount

Created 12/30/05

ST2

TRICARE STATEMENT EXAMPLES
(continuación)
Ejemplo 2: TRICARE Sureste

Ejemplo 3: Administración WPS TRICARE

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Charge

Total
Charge
Medicare
Approve
d Amount

Medicare
Approved
Amount

Medicare
Payment
Medicare
Payment