Name	Value
CODE	MA77
STATUS EFFECTIVE DATE	2003-06-01 00:00:00 STATUS: ACTIVE FEE USE: NOT APPLICABLE
DESCRIPTION EFFECTIVE DATE	DESCRIPTION: Alert: The patient overpaid you. You must issue the patient a refund within 30 days for the difference between the patients payment less the total of our and other payer payments and the amount shown as patient responsibility on this notice

Name

Value

CODE

MA77

STATUS EFFECTIVE DATE

2003-06-01 00:00:00

STATUS: ACTIVE

FEE USE: NOT APPLICABLE

DESCRIPTION EFFECTIVE DATE

DESCRIPTION:

Alert: The patient overpaid you. You must issue the patient a refund within 30 days for the difference between the patients payment less the total of our and other payer payments and the amount shown as patient responsibility on this notice

MA77 (274) REMITTANCE REMARK (161.93)