200 (207) ADJUSTMENT REASON (161.91)

Name	Value
CODE	200
STATUS EFFECTIVE DATE	2006-10-31 00:00:00 STATUS: ACTIVE FEE USE: APPLICABLE
DESCRIPTION EFFECTIVE DATE	DESCRIPTION: Expenses incurred during lapse in coverage
SUSPENSION DESCRIPTION	Expenses incurred during lapse in coverage
REMITTANCE REMARK
CORE SCENARIO	Billed Service Not Covered
ADJUSTMENT GROUP