DOD - 1000018439
Who is the PCM?
Marinis
What state does this bene live in?
North Dakota
What is the bene's name?
Beth Sanford
1234567890
What is the last 4 of bene's SSN?
9012
What plan does this bene have?
TRICARE Prime Individual Coverage for Active Duty Sponsors
What is the bene's status?
National Guard member
What is the street address for the bene?
1037 Kirlin Orchard Suite 33
What is the Plan/Account ID?
830169667
What is the DBN?
10003803801
What is the email of the Program Contact?
ksobera@triwest.com
What is the case number for the most recent activity?
00011248
what is the bene's email?
jdoe@gmail.com
What is the date and time of the most recent case?
12/18/2024 7:01 AM
What is the care plan start date?
8/17/2023
What is the bene's DOB?
9/22/2003
When does the Authorization to Disclose expire for the spouse?
13/08/2024
What is the program contact's phone number?
602-555-5555
What is the HCC end date?
1/15/2025
Who is the provider for claim #00000623?
Isaac Riley, DDS
Who is the "owner" of the most recent engagement?
mzinn
What is the Individual Catastrophic Cap Deductible Total Non-Network?
1204
What is the most recent Medical Appeal Submission date?
09-06-2024
What is the Last Engagement Interaction ID?
0u3SL0000002rwHYAQ
What is the date/time this account was created?
9/23/2024 6:32 AM