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

CHARITY MED B/D-COINS 0 ADJ 0
CHARITY MDCR B/D-N/C 0 ADJ 0
STATE MDCR B/D-DED 0 ADJ 0
STATE MDCR B/D-COINS 0 ADJ 0
STATE MDCR B/D-C=N/C 0 ADJ 0
MAINE MEDICAID ALLOWANCE 0 0
SELF PAY B/D O/P ALLOW 0 0
SELF PAY P/R DEDUCTION 0 AD 0
B/D RETURNED CHECK 0 NSF 0
B/D RETURNED CHECK 0 FEE 0
B/D PATIENT CASH TRANSFER 0 0
B/D INS CASH TRANFER 0 0
MDCR MGD CARE BD 0OP ALLOW0
MDCR MGD CARE BD 0IP ALLOW 0
CHAMPUS/TRICARE B/D 0 ALLOW 0
EBPA B/D ALLOWANCE 0 0
CHARITY B/D MDCR-DED 0 ADJ 0
CHARITY B/D MED-COINS 0 ADJ 0
CHARITY B/D MDCR-N/C 0 ADJ 0
STATE B/D MDCR-DED 0 ADJ 0
STATE B/D MDCR-COINS 0 ADJ 0
STATE B/D MDCRE-N/C 0 ADJ 0
T-MED B/D I/P COST REPORT 0 0
T-MED B/D O/P COST 0REPORT
0
SELF PAY B/D PAYMENT 0 0
MEDICARE MGD CARE 0 B/D PMT 0
TFR MEDICARE B/D COST 0 RPT 0
MEDICAL CLAIMS SERV 0 PYMT 0
MEDSPAN, INC. PYMT0 0