Name	Value
CODE	MA59
STATUS EFFECTIVE DATE	2003-06-01 00:00:00 STATUS: ACTIVE FEE USE: NOT APPLICABLE
DESCRIPTION EFFECTIVE DATE	DESCRIPTION: Alert: The patient overpaid you for these services. You must issue the patient a refund within 30 days for the difference between his/her payment and the total amount shown as patient responsibility on this notice.

Name

Value

CODE

MA59

STATUS EFFECTIVE DATE

2003-06-01 00:00:00

STATUS: ACTIVE

FEE USE: NOT APPLICABLE

DESCRIPTION EFFECTIVE DATE

DESCRIPTION:

Alert: The patient overpaid you for these services. You must issue the patient a refund within 30 days for the difference between his/her payment and the total amount shown as patient responsibility on this notice.

MA59 (257) REMITTANCE REMARK (161.93)