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