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Employee HMO Primary Care Provider Detail

Details

Employee HMO Primary Care Provider Detail

Fields on the Employee HMO Primary Care Provider Detail

• Employee Number.  The employee for whom the detail applies.
• Benefit.  The benefit plan for which the primary care plan provider information is valid.
• Employee -->.  Enter the primary care provider identification number or code for the employee's designated primary care provider.
• Dependent 1-9.  Select the dependent(s). Per row, in the field to the right, enter the corresponding primary care provider number or code for the selected dependent.