HomeMy WebLinkAboutInv# 4722061 - AMERIFLEX - 06/13/2025Ameriflex
P.O. Box 870217
Kansas City, MO 641870217
AMERIFLEX CLAIM INVOICE
Toll Free: 844.423.4636
Group Date Invoice #
City of Dania Beach 06/13/2025 4722061
Description Amount
Claims activity from 06/06/2025 to 06/12/2025 $203.62
Plan Year Type Location Name Social Security
Number Claim Date Transaction
Date
Transaction
Type Amount
Current FSA BARBARA
UROW XXXXX8608 06/03/2025 06/05/2025 CARD $130.00
Current FSA BARBARA
UROW XXXXX8608 06/05/2025 06/06/2025 CARD $30.00
Current FSA Travis Campbell XXXXX6883 06/05/2025 06/06/2025 CARD $30.00
Current FSA BARBARA
UROW XXXXX8608 06/06/2025 06/08/2025 CARD $10.00
Current FSA Subtotal $200.00
Total $200.00
Processing $3.62
Grand Total $203.62
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