chrg# cdsc cdept csrv cupr crev# 3095 med/surg, semi ... - CT.gov

PERSONAL PYMT (P/R -37DED)
-37
TCORS PYMNT 0 0
MBSC PAYMENT 0 0
CARE PAYMENT -153 -153
CAREPYMT ADD ON 17 PYMT 17
CARE PAYMENT RECOURSE 0 PYT 0
STATE PENDING PAYMENT 0 0
STATE SPENDDOWN -1 PMT -1
SAGA PENDING PAYMENT 0 0
MEDICARE PMT -5501 -5501
MEDICARE INPT B PMT 0 0
TRAILBLAZER PAYMENT 0 0
MEDICARE APPEALS -1 PYMT -1
HN SMARTCHOICE PMT 0 0
FALLON SENIOR PMT-5 -5
BLUE CHIP MEDICARE -7PMT
-7
TUFTS MCR PREF PMT0 0
AMER PROG T/OPTION 0 PMT 0
EVERCARE MEDICARE -1PMT
-1
CONNECTICARE MEDICARE -233 PMT -233
HEALTHNET PEARL MCR 0 PMT 0
AETNA MEDICARE ADV -28 PMT -28
MEDICARE MGD CARE 12 PMT 12
CIGNA MEDICARE ADV -1 PMT -1
AARP MED COMPLETE -482 PAYMENT -482
PSYCH NHM MED AV 0PAYMENT
0
PSYCH UNTD BEHV MED 24 PYMT 24
MEDIBLUE PAYMENT -21 -21
PSYCH BEAC HLTH MEDI 0 PAY 0
MEDICARE SECONDARY 27 PMT 27
SUPP STATE PAYMENT -129 -129
SUPP BLUE CROSS -406 PYMT -406
SUPP AARP/UHC PAYMENT -447 -447
SUPP UMR PMT -2 -2
SUPP AETNA PAYMENT 0 0
SUPP OXFORD HEALTHCARE -28 -28
SUPP AMER PROGRESS 1 PYMT 1
SUPP CT CARPENTERS 0LCL 24 0
SUPP BANKERS LIFE -1 PYMT -1
SUPP CELTIC LIFE PYMT 0 0
SUPP CHAMPVA PAYMENT -5 -5
SUPP COMBINE INS PYMT 0 0
SUPP EBPA PAYMENT0 0
SUPP HEALTHNET PYMT 0 0
SUPP MONUMENTAL -3LIFE PYMT-3
SUPP MUTUAL OF OMAHA -12 PYMT -12
SUPP STIRLING & STIR -76 PYMT -76