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Accounts Account Summary

01/01/2019 - 12/31/2019 Summary
	DATE OF SERVICE	ACCOUNT	MERCHANT/PROVIDER	CLAIM STATUS	AMOUNT
Show details for Limited Purpose FSA of 01/01/2019 - 12/31/2019 plan year	11/07/20YY	Limited Purpose FSA	-	Scheduled Reimbursement	$300.00
Claim Details Claim Number: BFDG230106C0000405 Recipient: Scott Sample Payee: Sally Sample Source: Administrator Receipt Status: Received Date(s) of Service: 11/17/20YY Pending: $300.00 View Confirmation
Show details for Dependent Care FSA of 01/01/2019 - 12/31/2019 plan year	10/01/20YY	Limited Purpose FSA	-	Paid	$75.00
Claim Details Claim Number: BFDG230106C0000404 Recipient: Sam Sample Payee: Sally Sample Source: Administrator Receipt Status: Received Date(s) of Service: 10/01/20YY Paid: $75.00 View Confirmation
Show details for Parking of 01/01/2019 - 12/31/2019 plan year	08/09/20YY	Limited Purpose FSA	-	Paid	$75.00
Claim Details Claim Number: BFDG230106C0000404 Recipient: Scott Sample Payee: Sally Sample Source: Administrator Receipt Status: Received Date(s) of Service: 08/09/20YY Paid: $75.00 View Confirmation
Show details for Transit Acct of 01/01/2019 - 12/31/2019 plan year	07/05/20YY	Limted Purpose FSA	Eye Doctor	Paid	$250.00
Claim Details Claim Number: BFDG230106C0000402 Recipient: Scott Sample Payee: Sally Sample Source: Administrator Receipt Status: Received Date(s) of Service: 07/05/20YY Paid: $250.00 View Confirmation