111 (133) ADJUSTMENT REASON (161.91)
Name
Value
CODE
111
STATUS EFFECTIVE DATE
2003-06-01 00:00:00
STATUS: ACTIVE
FEE USE: APPLICABLE
DESCRIPTION EFFECTIVE DATE
DESCRIPTION:
Not covered unless the provider accepts assignment.
SUSPENSION DESCRIPTION
Not covered unless the provider accepts assignment.
CORE SCENARIO
Billed Service Not Covered
ADJUSTMENT GROUP