Payer Report Data File

9999|209999|079999|CHI01|3429|20090324|064500|9999A 260|GREEN|LUIS|A|20081203|20081203| 000000000000210.10|20090324|WHITE HOBDY||1851349999||||||||922379999|0907911308515079999|A1:19:PR:65|M - INFORMATIONAL|||||||||090791130PPPP|090791130PPPP|A1:19:PR:65| ACK,RECPT- CLM,ENCOUNTER RECEIVED. DOES NOT MEAN THAT CLM HAS BEEN ACCEPTD FOR ADJUDICATION.:ENTITY ACKNOWLEDGES RECEIPT OF CLAIM, ENCOUNTER.||277 DATA FILE||660689999|0001|9999A 260|GREEN|LUIS|A|20089999|20089999| 000000000000210.10|922379999|1851349999||||

9999|209999|079999|CHI01|3429|20090324|064500|9999A 260|GREEN|LUIS|A|20081210|20089999| 000000000000210.10|20099999|WHITE HOBDY||1851349999||||||||922379999|0907911308516079999|A1:19:PR:65|M - INFORMATIONAL|||||||||0907911309999|0907911309999|A1:19:PR:65| ACK,RECPT- CLM,ENCOUNTER RECEIVED. DOES NOT MEAN THAT CLM HAS BEEN ACCEPTD FOR ADJUDICATION.:ENTITY ACKNOWLEDGES RECEIPT OF CLAIM, ENCOUNTER.||277 DATA FILE||660689999|0001|9999A 260|GREEN|LUIS|A|20081210|20081210| 000000000000210.10|922379999|1851349999||||