HomeMy WebLinkAboutInv# 4732817 - AMERIFLEX - 06/27/2025Ameriflex
P.O. Box 870217
Kansas City, MO 641870217
AMERIFLEX CLAIM INVOICE
Toll Free: 844.423.4636
Group Date Invoice #
City of Dania Beach 06/27/2025 4732817
Description Amount
Claims activity from 06/20/2025 to 06/26/2025 $164.67
Plan Year Type Location Name Social Security
Number Claim Date Transaction
Date
Transaction
Type Amount
Current FSA KENNITH
JOHNSON JR XXXXX0217 06/18/2025 06/19/2025 CARD $30.00
Current FSA KENNITH
JOHNSON JR XXXXX0217 06/18/2025 06/19/2025 CARD $30.00
Current FSA JERRYLYN CROSS XXXXX3296 06/22/2025 06/23/2025 CARD $15.00
Current FSA KENNITH
JOHNSON JR XXXXX0217 06/23/2025 06/24/2025 CARD $10.00
Current FSA CORINNE LAJOIE XXXXX7765 06/15/2025 06/24/2025 Manual
Claim $76.74
Current FSA Subtotal $161.74
Total $161.74
Processing $2.93
Grand Total $164.67
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