B5 (253) ADJUSTMENT REASON (161.91)

Name	Value
CODE	B5
STATUS EFFECTIVE DATE	2003-06-01 00:00:00 STATUS: ACTIVE FEE USE: APPLICABLE 2016-05-01 00:00:00 STATUS: INACTIVE FEE USE: APPLICABLE
DESCRIPTION EFFECTIVE DATE	DESCRIPTION: Coverage/program guidelines were not met or were exceeded. DESCRIPTION: Coverage/program guidelines were not met or were exceeded.
SUSPENSION DESCRIPTION	Coverage/program guidelines were not met or were exceeded.