D23 (289)    ADJUSTMENT REASON (161.91)

• 2009-11-01 00:00:00
  STATUS:   ACTIVE
  FEE USE:   NOT APPLICABLE
• 2012-01-01 00:00:00
  STATUS:   INACTIVE
  FEE USE:   APPLICABLE

• DESCRIPTION:   

  This dual eligible patient is covered by Medicare Part D per Medicare 
  Retro-Eligibility. At least one Remark Code must be provided (may be 
  comprised of either the NCPDP Reject Reason Code, or Remittance Advice 
  Remark Code that is not an ALERT.)
  

Remark Code that is not an ALERT.)