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Home My WebLink AboutCORRESPONDENCE - PURCHASE ORDER - 9146681Kroger Pharmacy Marketed Accounts PO Box 677575 Dallas, TX 75267-7575 855-840-5180 Federal TIN: 48.0196590 Plan ID: 4001218 KS FLU CLINIC -FORT COLLINS PO BOX 580 FORT COLLINS, CO, 80522 Please refer to the attached detailed statement for activity Included on this billing cycle. Invoice Number 20141018420 Statement Date 11/6/2014 Due Date Due Upon Receipt Total Amount Due $345.00 Current: $345.00 Over 60 days: $0.00 Over 90 days: $0.00 Over 120+ days: $0.00 For questions, please contact Kroger Pharmacy Accounts Receivable toll free at 855-840-5180 or email us at mcmtomemervlce@kroger.com. Please review Your account promptly and advise if payments have been made. Please contact your local Pharmacy If any of the prescriptions listed should have been submitted to other Insurance or to Medicaid/Medicare. Allow 2 weeks for payment processing. We appreciate your business) IlrfT-5FY-Tt"ffir4FT,TJ7Js n ,. u• t „r..t t u If payment is not made In full, please send additional detail with remittance. Plan ID 4001218 Statement Date 11/6/2014 Invoice Number 20141018420 Amount Due $345.00 Amount Enclosed REMIT PAYMENT TO: Kroger Marketed Plans Kroger Pharmacy Marketed Accounts PO Box 677575 Dallas, TX 75267-7575 Confidminlity Notice: The Information, including my a umonts, in Ibis message may contain privileged end confidential Information , It is intended solely forthe individua(s) aeoliy to which it is ndd..d to as listed nhove. Ifym. net the ms ded recipica, you ore hereby notified that any di closure, cepyins, distributing, or ao ofthe mama ofdds iofomW im is prohibited and mlawra. lfyou have received this mesuge in nrar, phxise mpiy imnedietely thatyou have received this manage m ertarorid demay a. Thank you fa you roopumdoet Pao, I of I I - 3-77.0 �' Kroger Pharmacy Marketed Accounts 1W PO Box 677575 Dallas,-TX 18067-7575 ., 5 f.., Federal TIN: 48-0196590 it Plan ID: 4001263 . ! ill . , KS FLU CLINIC -CITY OF FT COLLINS N/A N/A, NA, N/A Please refer to the attached detailed statement for activity Included on this billing cycle. Invoke Number 20141018463 Statement Date 11/6/2014 Due Date Due Upon Receipt Total Amount Due $11,760.00 Current: $11,760.00 Over 60 days:' _ $0.00 Over 90 days: $000 Over 120+ days: - $0.00 IT: For questions, please contact Kroger Pharmacy Accounts Receivable toll free at 855-840-5180 or email us at rxcustomersemice@kroger.com. Please review your account promptly and advise If payments have been made. Please contact your local Pharmacy If any of the prescriptions listed should have been submitted to other Insurance or to Medicaid/Medlcare. Allow 2 weeks for payment processing. We appreciate your businessl Please retain the too portion for your records. Tear alono fine and return bottom oortlon with your payment If payment is not made in full, please send additional detall.with remittance. Plan ID 4001263 Statement Date 11/6/2014 Invoice Number 20141018463 Amount Due $11,760.OD Amount Enclosed REMIT PAYMENT TO: Kroger Marketed Mans Kroger Pharmacy Marketed Accounts PO Box 677575 Dallas, TX 75267r7575 .Adrndelily .Iowa%; Ifyw