Insurance Information

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John Doe

Patient ID: #12345

Primary Insurance

Blue Cross Blue Shield

Member ID

MEM456789

Group Number

GRP987654

Plan Type

PPO

Status

✅ Active

Coverage Overview

Deductible

$1200 of $200060%

Out-of-Pocket Maximum

$2500 of $500050%

Copayments

Primary Care: $25
Specialist: $50
Urgent Care: $75
Emergency: $250