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1500Optum Claims
PO BOX 30760
Salt Lake City, UT 841300760HEALTH INSURANCE CLAIM FORM
APPROVED BY NATIONAL UNIFORM CLAIM COMMITTEE 08/05
PICA
MEDICAREMEDICAID(Medicare #)(Medicaid #)TRI CARE
CAMPUS
(Sponsors
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PO Box 30760 is a specific postal box address used for receiving mail.
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Any individual or organization that wishes to use PO Box 30760 as their mailing address would be required to file it.
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To fill out PO Box 30760, one would need to write the PO Box number, 30760, in the address line of any correspondence.
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