Understanding your new ID card - UMR

Understanding your new ID card 2019 United HealthCare Services, Inc. UM0092-CC 1019 (FS0018)No part of this document may be reproduced without permission. Issuer (80840) 911-39026-02 Member ID: Group Number:Member:Dependents:SUSAN M SAMPLE 01 MED DEN VISC opays:Office $20 / Spec $405010 Administered by UMR Teladoc $1034376414038176-414038 JONATHON G SAMPLE 00 MED DEN VISI ssuer (80840) 911-39026-02 Member ID: Group Number:Member:Dependents:SUSAN M SAMPLE 01 MED DEN VISC opays:Office $20 / Spec $405010 Administered by UMR Teladoc $1034376414038176-414038 JONATHON G SAMPLE 00 MED DEN VIS03122 9590397 0000 0000290 0000282 277 6 116 03122 9590397 0000 0000290 0000282 277 6 116 RUN_DATE 20191005 17:48.

Claims: EDI # 39026, UMR, PO Box 30541, Salt Lake City, UT 84130-0541 Vision Claims: Spectera Vision, PO Box 30978, Salt Lake City, UT 84130 This card must be presented each time services are requested. Printed: 10-03-2019 Call UMR at the member customer service number listed on this ID Card for plan required prior authorization.

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  City, Salt, Lake, 10483, 14350, Salt lake city, Ut 84130, Po box, Po box 30541

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