272 (363) ADJUSTMENT REASON (161.91)

Name	Value
CODE	272
STATUS EFFECTIVE DATE	2015-11-01 00:00:00 STATUS: ACTIVE FEE USE: APPLICABLE
DESCRIPTION EFFECTIVE DATE	DESCRIPTION: Coverage/program guidelines were not met.
SUSPENSION DESCRIPTION	Coverage/program guidelines were not met.
REMITTANCE REMARK
CORE SCENARIO	Billed Service Not Covered
ADJUSTMENT GROUP