33 (79) ADJUSTMENT REASON (161.91)

Name	Value
CODE	33
STATUS EFFECTIVE DATE	2003-06-01 00:00:00 STATUS: ACTIVE FEE USE: APPLICABLE
DESCRIPTION EFFECTIVE DATE	DESCRIPTION: Insured has no dependent coverage. DESCRIPTION: Insured has no dependent coverage.
SUSPENSION DESCRIPTION	Insured has no dependent coverage.
REMITTANCE REMARK
CORE SCENARIO	Billed Service Not Covered
ADJUSTMENT GROUP