| Name | Value |
|---|---|
| CODE | 228 |
| STATUS EFFECTIVE DATE |
|
| DESCRIPTION EFFECTIVE DATE |
|
| SUSPENSION DESCRIPTION | Denied for failure of this provider, another provider or the subscriber to supply requested information to a previous payer for their adjudication |
| REMITTANCE REMARK |
|
| CORE SCENARIO | Billed Service Not Covered |
| ADJUSTMENT GROUP |
|