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Important information
- Customer Complaint:
BBB’s profile for Blue Shield of California, was created June 1956. A review of the file was done in September 2024. Complaints on file concern billing and authorization issues.
BBB recommends patients and providers to review the Prior Authorization List and File A Grievance.
For additional support, please visit Blue Shield of California's Contact Us.
Complaints
This profile includes complaints for Blue Shield Of California's headquarters and its corporate-owned locations. To view all corporate locations, see
Customer Complaints Summary
- 120 total complaints in the last 3 years.
- 43 complaints closed in the last 12 months.
If you've experienced an issue
Submit a ComplaintThe complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.
Initial Complaint
Date:07/24/2025
Type:Service or Repair IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
Terrible service for breast pump. I live outside of California, and all preferred providers for breast pump do not deliver in the state I live (*************). Two out of the three customer **** I called were not able to provide the correct information and I was terribly misguided. Why does Blue CA have to make it so hard for an expecting mother to get a breast pump? If this is a benefit, why is it not easily accessible? The first *** i called provided list of providers and asked me to call ***************. The *** at Yummy Mummy told me they dont do deliveries in ** and asked me to call back insurance. The second *** from Blue CA said I need to go through my doctor to get a breast pump. I called a third ***, and after spending 1.5 hours, she gave me a link to try. I still dont know if i can a breast pump through my insurance, BlueCA. She also provided a form for reimbursement which has ONLY mailing option, there's no EMAIL option. Let me remind BlueCA, it's 2025, not 1925. Terrible terrible experience with ******, especially as an expecting mother, I would think my insurance would make my life easier, but it has just been the opposite of that.Business Response
Date: 07/25/2025
We thank you for forwarding these concerns to Blue Shield of California (Blue Shield). We would like to inform you that we have initiated a grievance analysis to review and respond to the concerns raised in the correspondence submitted. We will provide a written response to ****** ***** within 30 calendar days. We have mailed an acknowledgment letter to ************************* mailing address with additional information regarding the grievance process, as well as the phone number for our ********************* Thank youInitial Complaint
Date:05/27/2025
Type:Service or Repair IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I cancelled my policy on December 31, 2024. On January 2, 2025 Blue Shield took out $2269.40 out of my account. They have acknowledged that they will refund the money to me. They have told me that they have mailed it out and it will be here in 7-10 days. It has been 5 months. I have called them 9 times. I have asked to speak to a supervisor several times and have never been allowed to speak to one. I have talked to Crystal, ****** ****** ******** Yahida and ******. 2 other people I did not get their names.Business Response
Date: 05/27/2025
We thank you for forwarding these concerns to Blue Shield of California (Blue Shield). We would like to inform you that we have initiated a grievance analysis to review and respond to the concerns raised in the correspondence submitted. We will provide a written response to ******** ******* within 30 calendar days. We have mailed an acknowledgment letter to ********************** mailing address with additional information regarding the grievance process, as well as the phone number for our ********************* Thank youInitial Complaint
Date:05/20/2025
Type:Order IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I am a ******* member residing overseas and enrolled in the **** Platinum PPO plan, which transitioned from Anthem to Blue Shield of California in January 2025. Since that switch, all of my foreign medical claims have been denied even for services that were routinely covered in prior years under ********* first two claims under Blue Shield were denied, then denied again on appeal but were eventually reversed and paid in full after further escalation. However, subsequent identical claims have continued to be denied, without meaningful explanation or change in processing behavior. It appears that the reversal of my initial denials had no effect on the underlying systemic issue.Even representatives from Included Health, who act as claim advocates for ******* members, have expressed frustration. They report that they are unable to get consistent answers from Blue Shield about how foreign claims are being handled, and have no internal policy guidance to rely on.This lack of transparency, consistency, and accountability is unacceptable especially for those of us living abroad who rely on this coverage for essential care. The financial and health impacts are mounting, and we have no reliable way to receive reimbursement or clarity.A full explanation of the complaint is contained in the attachment along with supporting documentsBusiness Response
Date: 05/30/2025
We thank you for forwarding these concerns to Blue Shield of California (Blue Shield). Our records indicate this member currently has a grievance in review, received on 05/14/2025 regarding these specific concerns. Please note that grievances are reviewed and responded to via the ******************* within 30 calendar days. Therefore, we will not initiate a secondary review at this time.Initial Complaint
Date:04/30/2025
Type:Service or Repair IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I am covered for ***************** with Blue Shield of CA, member ID *********. My medical insurance coverage with them started on 01/01/2025. On 01/20/2025, I paid $171 for a prescription medicine (********* 500 mg), when I picked it up from Rite-Aid pharmacy located at *************************************. This medicine was supposed to be $0.00 copay for me based on my coverage.Since then, I have followed up with Blue Shield of CA multiple times, but to no avail. They even sent me a letter responding to my grievance on 03/14/2025, that they found an issue on their end, because of which my benefits did not apply correctly, and that their pharmacy department will reach out to me for a resolution within 7-14 days, but it has been 6 weeks since then, and nobody reached out to me. During this time, I have reached out to Blue Shield about 4 times, each time hanging on the call with their support team for more than ***** mins. They keep transferring my call between departments, and eventually the call disconnects. It has been a very frustrating customer service experience for me following up with them, for something that was not my fault. I just want them to pay my due of $171.00, which I was not supposed to pay, in the first place. I also want to charge them an additional $500 for the waste of my time that they have caused me with this unnecessary follow up.Business Response
Date: 04/30/2025
We thank you for forwarding these concerns to Blue Shield of California (Blue Shield). We would like to inform you that we have initiated a grievance analysis to review and respond to the concerns raised in the correspondence submitted. We will provide a written response to ****** Gupta within 30 calendar days. We have mailed an acknowledgment letter to ************************************* mailing address with additional information regarding the grievance process, as well as the phone number for our ********************* Thank you.Customer Answer
Date: 05/01/2025
Complaint: 23269990
I am rejecting this response because:My first report of this issue was on Feb-13-2025. I received the first response from BlueShield CA on 14-Mar-2025, in which they promised to revert to me with a resolution in the next 7-14 days. However, from then until now, I have made several phone calls to them (over 45 min each), and I have not been given any satisfactory resolution. Their customer service is extremely poor in handling this case, I want this to be escalated to get attention from someone responsible, and get me my due payment of $171 as soon as possible. Being an error on their side, this is a very long time and painful process to get this settled.
Sincerely,
****** *****Initial Complaint
Date:04/25/2025
Type:Order IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
Since my injury in 2022, I have been repeatedly denied necessary, doctor-recommended medical care by Blue Shield, especially chiropractic and acupuncture treatments that are essential for managing my pain and *****************. Ive submitted multiple grievances and appeals with proper medical documentation from licensed physicians including Dr. ******* and Dr. **** yet theyve continued to deny or delay care. Ive experienced discrimination based on my disability and financial hardship. Their repeated denials have caused immense physical suffering, emotional distress, and prolonged recovery. Ive paid out of pocketover $30,000to keep myself alive, while Blue Shield refused coverage for treatments that were clearly medically necessary.I filed formal complaints with multiple government agencies and sent copies to Blue Shield, yet I continue to face the same neglect and dismissiveness. Ive received only one chiropractic session, despite being approved for more, and have yet to access the 12 sessions my doctor recommended. Im underweight, unable to sleep properly due to pain, and still recovering from severe injuries that were never treated. Their behavior has been cruel and dismissive, causing further damage to my health and stability. I am asking for urgent intervention to stop this mistreatment and ensure I receive the ongoing care I need and deserve.Business Response
Date: 04/25/2025
We thank you for forwarding these concerns to Blue Shield of California Promise Health Plan. We would like to inform you that we have initiated a grievance analysis to review and respond to the concerns raised in the correspondence submitted. We will provide a written response to Emek Echo within 72 hours. We will mail a resolution letter to Emek Echo's mailing address with information regarding the grievance resolution, as well as the phone number for our Grievance Department. Thank you.
Customer Answer
Date: 04/28/2025
Complaint: 23248898
I am rejecting this response because:
Blue Shield continues their abuse. This time on their Call the Car ride service. Please add to my complaint.
**Subject: Emek Echo - Formal Complaint Against Call the *********** Representative Blueshield of California**
**Blueshield** and their **Call the ************* abuse: 4/28/2025
To Whom It May Concern,
I am submitting this formal complaint regarding an extremely distressing and unacceptable experience I had today with the Call the *********** representative named ********.
On **April 28, 2025**, at **4:01 PM**, I was forced due to routine failure on their app for call their Call the Car ride service for patients, at their************** number, to schedule transportation services, as authorized by my health plan.
Rather than assisting me promptly, ******** subjected me to approximately **7 minutes of unnecessary, abusive, and unprofessional behavior**, adding significant emotional distress to my already fragile and severely disabled condition.
Despite clearly informing her (calmly and respectfully) that I am disabled, medically documented, and that speaking on the phone causes me **severe anxiety and exacerbates my health conditions** information that has been repeatedly reported to Blueshield since 2023. **** was indifferent, dismissive, and combative.
Instead of efficiently providing the service within a few minutes as required, she repeatedly talked over me, refused to listen to my basic needs, and escalated the conversation unnecessarily.
I specifically told her that my complaints were not directed at her personally, but toward Blue Shields policies and services.
Despite this clear explanation, she continued to take it personally, which is highly unprofessional and inappropriate, especially for someone working in a health-related customer service role assisting patients.
Her behavior was irrational, emotionally unstable, and entirely unacceptable in a healthcare setting where compassion, professionalism, and calm communication are critical.
Her conduct was unprofessional, uncompassionate, and hostile toward a disabled patient simply trying to schedule medical transportation.
I am deeply concerned that Blueshield continues to employ representatives who clearly **lack the training, sensitivity, and professionalism** required to work with patients with disabilities, despite being informed of the harm this causes.
It is not acceptable to require a disabled person to repeatedly explain their disability and beg for basic accommodations. Once disability is declared, respect and understanding are legally required under the Americans with Disabilities Act (***).
Additionally, I have repeatedly informed Blueshield that the Call the Car app malfunctions regularly, and that being forced to call and endure this mistreatment over and over is detrimental to my health and safety. Yet no effective changes have been made.
I am demanding once again that Blueshield take immediate corrective action:
- **Properly train** all Call the Car representatives on disability sensitivity and *** compliance.
- **Discipline** **** for her unprofessional and harmful behavior during todays call.
- **Improve** the Call the Car app functionality to allow disabled users to schedule transportation independently without abusive human interaction.
- **Create a special accommodations process** for patients like myself to avoid these repeated traumatic interactions.
Please be advised that since Blue Shield abuse continues, I will escalate my complaints to state and federal agencies responsible for healthcare discrimination and patient rights protections.
I am documenting every incident carefully.
Sincerely,
Emek Echo
***************************Business Response
Date: 04/30/2025
The member has requested multiple specialists be approved; our investigation shows all referrals have been approved within the access to care guidelines provided by the ****. We have attempted to reach this member to discuss her concerns,however, the member has alleged that our calls may trigger her to have a medical emergency; therefore,she refuses to speak with us. The **** requires we contact the member to provide her with her rights; however, the member refuses to speak with us. We have addressed all concerns via US postal Mail and have educated the member on the guidelines that are enforced by our regulators. We regret that the member is not satisfied with the services provided, however, we have found no delay in care and no denials of service have been provided. We will address the members most recent concerns directly with the member.
We thank you for forwarding these concerns to Blue Shield of California Promise Health Plan. We would like to inform you that we have initiated a grievance analysis to review and respond to the concerns raised in the new correspondence submitted. We will mail a resolution letter to the members mailing address with information regarding the grievance resolution, Thank you.Customer Answer
Date: 04/30/2025
I am rejecting this response because:
Complaint: 23248898
**Public Response from Emek Echo:**
**Subject:** Emek Echo - Ongoing Abusive Conduct by Blue Shield - Disability Rights Violations, Medical Neglect, and Retaliatory Misrepresentation 4/30/2025
Blue Shield of California's response is not only dismissive, it is dangerous, dishonest, and reflective of the very systemic abuse I outlined in my original complaint dated April 24, 2025.
To suggest I "refuse" to speak with them when I have *filed a police report* to stop harassing calls, due to the trauma and emotional distress they have caused by consistently violating my disability rights, is a gross misrepresentation.
I have repeatedly informed Blue Shield in writing that phone calls are medically and psychologically harmful due to my disability, and Ive asked for **reasonable accommodations** in accordance with **state and federal disability laws**.
These include written communication and accessible, consistent coordination of care. They refuse.
Further, the claim that no denials of service have been provided is outright false. I have *over 45 documented grievance denials* from Blue Shield in my possession, with more pending. This has been going on since July, 2023 when I first became their member.
I was severely injured by a violent and well-documented tackle in 2022, publicly available video evidence proves the seriousness of my condition, and exposes the ongoing negligence by both ***************** and Blue Shield.
After Anthem failed to provide necessary care, I switched to Blue Shield in 2023, hoping for better treatment.
Instead, they denied me access to proper medical care entirely.
Ive had to pay out-of-pocket for life-saving acupuncture, and my doctor had to send me to the **** ER, which saved my life.
Blue Shield has not only failed to help, theyve actively contributed to the deterioration of my health.
I was a healthy, active, and productive individual before this injury. Their actions have devastated my life, and now they have the audacity to lie publicly about it.
Their gaslighting tactic to pretend there have been no delays in care is not only infuriating, it is legally and ethically indefensible.
These delays have caused me immense suffering, made worse by the bureaucratic obstacles they intentionally erect.
Blue Shield has continuously failed to act in good faith, obstructed medically necessary treatment, and knowingly violated the rights of a disabled person in crisis.
I have legal counsel reviewing this matter, and all relevant documentation, including this outrageous public response, will be added to a formal complaint to the ***** the Department of ******************** and additional regulatory bodies.
I also call on the leadership of Blue Shield to be held accountable. This is not just negligence, it is cruelty.
Its time for those responsible for this harm to resign and for competent, *human* professionals to take their place.
This abuse must end now!
Sincerely,
Emek EchoInitial Complaint
Date:04/22/2025
Type:Service or Repair IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I'm formally reaching out to the Better Business Bureau for help regarding a maternity claim for dates of service 02/07/2025. My claim has been processed and incorrectly paid to the provider when this was a self-submitted claim-The assignment of benefits is not accepted on the claim form and the claim is marked as paid in full. Please help me direct BS of California to issue the check correctly.Business Response
Date: 04/25/2025
We thank you for forwarding these concerns to Blue Shield of California (Blue Shield). We would like to inform you that we have initiated a grievance analysis to review and respond to the concerns raised in the correspondence submitted. We will provide a written response to ****** ******** within 30 calendar days. We have mailed an acknowledgment letter to ***************************************************** mailing address with additional information regarding the grievance process, as well as the phone number for our ********************* Thank you.Customer Answer
Date: 05/01/2025
Complaint: 23233516
I am rejecting this response because:
I never received the email they mentioned, and the checks still have not show up after two months. This is unacceptable and the checks must be reissued and this time to the correct recipient (me).Sincerely,
****** ********Initial Complaint
Date:04/21/2025
Type:Order IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
Im formally requesting help from the Better Business Bureau for help regarding a check that has been incorrectly issued to the provider.I submitted my own CMS1500 claim form through my BS of California member portal for direct reimbursement-As my Midwife does not accept insurance and has been paid in full. BS of California has processed my claim and issued the payment to the provider incorrectly.I am formally asking help from the Better Business Bureau in questioning BS of California as to why they incorrectly processed my claim and issuing the payment incorrectly.Business Response
Date: 04/22/2025
We thank you for forwarding these concerns to Blue Shield of California (Blue Shield). In order to research and properly respond to the members concerns, we ask that you provide the subscriber identification number of the account in question.Initial Complaint
Date:04/19/2025
Type:Product IssuesStatus:ResolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
Blue Shield sent me a letter on 12/19/2024 stating there was a decrease in my premium starting 1/01/2025. My new monthly payment was ******. On 1/16/25 I received an invoice for *******. I had paid four different payments. On 12/4/24 $232.15. 2/3/25 $280.00 2/18/25 $250.00 and 2/28/25 $216.44. I tried to get my blood pressure medication and they said my policy was expired due to non payment. I contacted Bliue Shield and Covered California. They both tried to blame each other for the error. I overpayed Blue Shield cause they were threatening to terminate my insurance coverage. I called and a nice lady said she would issue a refund and I will see it in my mailbox. I never did. When I contacted Blue Shield again they said, the refund was an error. I am so upset with the incompetence of my health insurance provider. I have always had insurance. I am receiving less benefits and it is costing me triple. I contacted Covered CA and they said Blue Shield terminated my policy for non payment on March 4th. When you read the bill for April its shows none of my payments and me owing $****** for the month. I refuse to send another payment until I get my refund for the amount I overpaid. Once again they are threatening my coverage cause my account is past due. I am at a loss and really hope you can help with this debacle. I paid 4 payments totaling $978.59 minus three months at ****** is $514.39. I expect a refund check for the difference which is $464.30. ThanksBusiness Response
Date: 04/22/2025
We thank you for forwarding these concerns to Blue Shield of California (Blue Shield). We would like to inform you that we have initiated a grievance analysis to review and respond to the concerns raised in the correspondence submitted. We will provide a written response to **** ****** within 30 calendar days. We have mailed an acknowledgment letter to ********************************** mailing address with additional information regarding the grievance process, as well as the phone number for our ********************* Thank youCustomer Answer
Date: 04/29/2025
Better Business Bureau:
I have reviewed the response made by the business in reference tocomplaint ID ********, and find that this resolution is satisfactory to me.
Sincerely,
**** ******Initial Complaint
Date:04/14/2025
Type:Service or Repair IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I am formally requesting the Better Business Bureau to please assist in helping me convey to my insurance company that a claim payment MUST be issued to my new address after the terrible California fires destroyed my home in *****************. My complaint is regarding claim number ************ is regarding a payment that has been issues to my old home address that was burned down during the terrible fires. Please assist my making BS of California accountable to sending my address to my current address: ********************************. I have conveyed the need to reissue the check to the correct mailing address multiple times to no avail. Please help!Business Response
Date: 04/14/2025
We thank you for forwarding these concerns to Blue Shield of California (Blue Shield). We would like to inform you that we have initiated a grievance analysis to review and respond to the concerns raised in the correspondence submitted. We will provide a written response to **** ******** within 30 calendar days. We have mailed an acknowledgment letter to ***************************** mailing address with additional information regarding the grievance process, as well as the phone number for our ********************* Thank you.Initial Complaint
Date:04/04/2025
Type:Product IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I am formally issuing a complaint against BlueShield of California as I have submitted a maternity claim through member services for reimbursement on a claim that was paid in full for a non-network provider. After multiple attempts to have the $802.27 check reissued to my address, I am formally requesting the Better Business Bureau to become involved as BS of California is continuing to send my reimbursement check to the provider who has been paid in full and does not accept insurance.Please find the following notes attached: Fri, Mar 28, 2025 at 6:30AM I requested a supervisor. After a lot of holding and waiting, I was told your check would be reissued to the member (as the previous requests were not completed as promised). Name: Angel ********* to call: ************ Supervisor Request:Supervisor name: Larc ********* to call: ************ Feb 11, 2025 at 9:48AM The check received by Aleks dated 12/10 has been successfully voided. The new check was reissued, but there are no details on the provider's side-***************** can only confirm the check is still outstanding.Claim number for re-issue is ************ Name: *** ********* to call: ************ Dec 26, 2024 at 8:25PM: I just finished a call with *** in the claims department, *** was able to request the check be reissued to you under reference number ************.Business Response
Date: 04/07/2025
We thank you for forwarding these concerns to Blue Shield of California (Blue Shield). We would like to inform you that we have initiated a grievance analysis to review and respond to the concerns raised in the correspondence submitted. We will provide a written response to Crystal ******************* 30 calendar days. We have mailed an acknowledgment letter to ****************************** mailing address with additional information regarding the grievance process, as well as the phone number for our ********************* Thank you.
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