27 (77) ADJUSTMENT REASON (161.91)

Name	Value
CODE	27
STATUS EFFECTIVE DATE	2003-06-01 00:00:00 STATUS: ACTIVE FEE USE: APPLICABLE
DESCRIPTION EFFECTIVE DATE	DESCRIPTION: Expenses incurred after coverage terminated.
SUSPENSION DESCRIPTION	Expenses incurred after coverage terminated.
REMITTANCE REMARK
CORE SCENARIO	Billed Service Not Covered
ADJUSTMENT GROUP