UM1 FEATURING THE RECEIVER UM1 MICRO DIVERSITY SYSTEM
your UM1 system was purchased in the United States, please call Samson at 1-800-372-6766 for a Return Authorization number prior to shipping your unit If possible, return the unit in its original carton and packing materials If your UM1 system was purchased outside of the U S , contact your local distributor for servicing information
UM1 SERIES RoHS Compliant - Fujitsu
UM1- 48 W-K 48 VDC 10,472 Ω +33 6 VDC +2 4 VDC 220 mW n COIL DATA CHART Note: *1 Specified values are subject to pulse wave voltage All values in the table are
Supplements to UM1 grants for NCI’s Early Therapeutics
Oct 01, 2017 · The current ETCTN consists of 12 UM1 grantee Lead Academic Organizations and their affiliates committed to conducting studies of NCI-IND agents with a phase 1 emphasis These UM1 grantees have incorporated a separate ETCTN Phase 2 Program that had consisted of 7 contract holders at major academic medical centers and their affiliates
COMMUNICATION CRYSTALS ULTRA MINIATURE • UM-1 • UM-4
abu, abu4 communication crystals ultra miniature • um-1 • um-4 standard specifications: 7 8 x 3 1 x 8 0 mm features: applications: parameters options & part identification:
UM Series of Printed Circuit Board Mountable, High Voltage
UM1*30 0 to 1KV 30mA 0 032 0 171 0 2μF 220Ω 6 5V 20MΩ UM2*30 0 to 2kV 15mA 0 031 0 112 0 097μF 470Ω 9 85V 30MΩ UM4*30 0 to 4kV 7 5mA 0 028 0 071 0 012μF 4 4KΩ 9 85V 100MΩ UM6*30 0 to 6kV 5mA 0 020 0 051 0 007μF 9 4KΩ 10 0V 150MΩ Note: Total ripple is the sum of the low frequency and high frequency ripple
NCI Experimental Therapeutics Clinical Trials Network(ETCTN
• The duration of the ETCTN UM1 and U24 PK awards has been extended to 6 years • Q & A regarding the FOAs will be posted on the CTEP website in the section related to the Experimental Therapeutics Clinical Trials Network • Due on May 22, 2019, by 5:00 PM local time of applicant organization
CCH-UM1-6CD6CE1232 CCH,G3,2X32,XB,SCAPC,SHORT,INDOOR ONLY
2 49 4 56 1 75 6 12 5 73 1 21 0 91 cch-um1-6cd6ce1232 cch,g3,2x32,xb,scapc,short,indoor only created date: 5/13/2013 11:15:58 am
Contender Series Factory Sealed Control Stations and Pilot Lights
NEC/CEC: Class I, Division 1, Groups C, D Class I, Division 2, Groups B, C, D Class II, Division 1 and 2, Groups E, F, G Class III NEMA 3, 7CD, 9EFG Contender
EFD/EFDB and EDS Series Factory Sealed Control Stations
NEC/CEC: Class I, Division 1 and 2, Groups B , C, D Class II, Division 1 and 2, Groups E, F, G Class III NEMA 3, 7CD, 9EFG EFD/EFDB and EDS Series Factory Sealed Control Stations
Commercial Remittance Advice Code Descriptions
Exp Code Text CARC RARC 24D Benefits for this service are limited to one time per six-month period 273 N435 25D This category of dental benefits has a waiting period as specified in this member's dental contract 179
[PDF] université montpellier 3
[PDF] comment ne pas gaspiller l'eau
[PDF] conseils pour éviter le gaspillage de l'eau wikipedia
[PDF] expression écrite sur le gaspillage de l'eau
[PDF] fahrenheit 451 texte intégral
[PDF] pour ne pas gaspiller l'électricité il ne faut pas
[PDF] pourquoi il ne faut pas gaspiller l'eau
[PDF] gaspillage de l'eau wikipédia
[PDF] gaspillage de l'eau conséquences
[PDF] fahrenheit 451 extrait du livre
[PDF] fahrenheit 451 thèmes abordés
[PDF] règles d'asepsie en milieu hospitalier
[PDF] fahrenheit 451 analyse contre utopie
[PDF] asepsie soins infirmiers
Exp. CodeTextCARCRARC
002This charge exceeds the maximum allowable under this member's coverage.45
008This service is limited by the member's plan. Benefits were extended by our Utilization Management department.119
018This charge exceeds the maximum allowable under this member's coverage 45
01DProcessing of this claim was suspended awaiting information requested from this provider or subscriber.133
02DBenefits for this service are limited to two times per contract year. 273N435
03DBenefits for this service are limited to one time per three-month period.273N435
04DBenefits for this service are limited to one time per thirty-six month period.273N435050This charge exceeds the maximum allowable under this member's coverage.59N644
7s7Change Secondary Allowed Units
9s9Change Secondary Deductible Amount
HIPAA-compliant electronic remittance advice (ANSI-835) will not use these explanation codes. The electronic remittance advice (ANSI-835) uses HIPAA-compliant remark and adjustment reason codes. Where appropriate, we have included the HIPAA-compliant remark and/or adjustment reason code that corresponds to a
BlueCross BlueShield of Tennessee explanation code. Standardized descriptions for the HIPAA adjustment reason and remark codes can be accessed on the Washington
Publishing Company Web site at http://www.wpc-edi.com/codes. *Updates are shaded in blue. (Revised 2/21/17)The following remittance explanation codes and descriptions reflect those found on hardcopy (paper) Commercial remittance advice. These same codes and
descriptions will also apply to online Commercial remittance advices, available on BlueAccess, the secure area of www.bcbst.com. Although the provider
action/information column does not appear on the remittance advice, we have included it on this document to assist you.For remittance advice that reflect dates of service of May 1, 2008 and after, explanation codes used for BlueCare Tennessee will also appear in this
listing.Commercial Remittance Advice Code Descriptions
Exp. CodeTextCARCRARC
u99This claim requires configuration review. 133054Services denied due to being delegated to another entity. 109N418
057We are deducting this amount because of an overpayment on a previous FSA claim.
05DBenefits for this service have a twelve-month waiting period. 179
062These expenses are not eligible since there is no money left in your Flexible Spending Account.187
066This is not a covered service under medical benefits. The service is eligible under the Health Reimbursement Account.96N30
068These expenses are not eligible since there is no money in your Flexible Spending Account.187
069These expenses are not eligible since there is no money in your Flexible Spending Account.187
06DThis service was performed on a previously missing tooth. 272
071Your Dependent Care Flexible Spending Account funds have been exhausted. Payment may be made when additional funds are available.187
073Benefits for this service are excluded under this member's plan. 96N216
07DBenefits for this service are limited to two times per twelve-month period.B5N640
08DServices for hospital charges, hospital visits, and drugs are not covered.96N216
09DServices for premedication and relative analgesia are not covered. 96N126
0DAThis is an adjustment to a previous dental claim that paid to the provider but should have paid to the subscriber.96MA67
104This member's coverage excludes benefits for the condition for which this service was rendered.96N216
10DBenefits for sealants and dietary instruction are not covered. 96N216
11DThe procedure code and tooth number filed do not correspond. An alternate procedure code was used for pricing.169
12DBenefits for this procedure are limited to once per lifetime, per tooth and tooth surface.119N587
Exp. CodeTextCARCRARC
13DAppliances due to wear and services to improve bite or to correct congenital or developmental problems are non-covered.96N216
14DBenefits for implants, TMJ (Temporomandibular Joint) Dysfunction and periodontal splinting are not covered.96N216
0s0Change Secondary Coinsurance Amount
0s1Change Secondary Copay Amount
077Long Term Care Hospital Override
15DBenefits for this service are limited to one time per three-month period.273N435
16DWe cannot process this claim until we receive previously requested information concerning the member's other insurance.22
17DBenefits for services that are considered to be primarily cosmetic are not covered.96N383
17dA portion of these services is considered primarily cosmetic and will not be covered.96N383
18DThis procedure is not covered, an allowance for a standard procedure was paid.169
19DBenefits for this service are limited to two times per calendar year. 273N435
1DAThis dental claim is being adjusted due to a corrected billing submitted by the provider.96MA67
1DOTemporary procedure has been deducted from the amount of the primary procedure.169
1s1Secondary Supplementation Amount
201Interest is being recouped. 85
20DRelines cannot be billed separately if done within six months of the primary denture and or partial procedure.273N435
21DBenefits for this service are limited to one time per sixty-month period.273N435
22DBenefits for this service have a twenty-four month waiting period. 179
23DThese benefits have been paid by the member's medical policy. 168
Exp. CodeTextCARCRARC
24DBenefits for this service are limited to one time per six-month period.273N435
25DThis category of dental benefits has a waiting period as specified in this member's dental contract.179
26DBenefits for this service are limited to one time per five-month period.273N435
27DBenefits for this dental service are not available, per this member's contract.96N216
28DBenefits for this service are limited to one time per twelve-month period.273N435
29DBenefits for this dental service are not available, per this member's contract.96N216
2s2Secondary Allow Amount
30DThis charge is a duplicate of a previously processed claim for this member.18N702
30dThis procedure is a duplicate of a previously filed procedure. 18N522
31DThis service is denied based on information submitted. Participating dentist should charge only amount in 'Patient Owes'.96N10
328This claim was adjusted to provide corrected benefits. 96MA67
32DBenefits for this service are limited to one time per four-month period.273N435
33DBenefits for this service are limited to one time per two-year period.273N435
341This claim was paid to the wrong payee. 96MA67
342This claim was paid to the wrong payee. 96MA67
343This claim was paid to the wrong payee. 96MA67
344This member's coverage under this plan was not in effect on the date this service was provided.27N30
345Benefits for this service are excluded under this member's plan. 96N30
346Duplicate of previous claim. If corrected billing, please resubmit according to billing guidelines.18N702
Exp. CodeTextCARCRARC
347Benefits for this service are excluded under this member's plan. 96N30
348Benefits are excluded for an on the job injury or for services eligible for Worker's Compensation benefits.19N418
349This claim was adjusted to provide benefits secondary to Medicare. 96MA67
34DBenefits for this service have a ninety-day waiting period. 179
350This is a subrogation adjustment. It will not effect previously assigned patient liability.215
351This claim was adjusted to provide benefits secondary to this member's other insurance coverage.96MA67
352This claim was previously processed under another member's name or ID number in error.96MA67
353This claim was previously processed under another member's name or ID number in error.96MA67
354This claim was adjusted to provide corrected benefits. 96MA67
355This claim was adjusted to provide corrected benefits. 96MA67
356This claim was adjusted to provide corrected benefits. 96MA67
35DBenefits for this service are limited to one time per twenty-four month period.273N435
365This claim was adjusted to provide corrected benefits. 96MA67
366This claim was adjusted to provide corrected benefits. 96MA67
367This claim was adjusted due to a change in provider information. 96MA67
368This claim was adjusted due to a change in provider information. 96MA67
369This claim was adjusted to provide benefits secondary to Medicare. 96MA67
36DThese benefits were previously paid under an incorrect provider status.170N95
370This claim was adjusted to provide corrected benefits. 96MA67
Exp. CodeTextCARCRARC
371This claim was adjusted to provide corrected benefits. 96MA67
379This is a subrogation adjustment. It will not effect previously assigned patient liability.215
37DThis service needs to be resubmitted using current American Dental Association procedure codes.181M20
37dThis service needs to be resubmitted using current American Dental Association procedure codes.181M20
380This claim was adjusted to provide benefits secondary to Medicare. 96MA67
381Please submit a copy of the Explanation of Benefits from this member's other insurance carrier.22MA92
382This claim was adjusted to provide benefits secondary to Medicare. 96MA67
383This claim was adjusted to provide corrected benefits. 96MA67
384This claim was adjusted to provide corrected benefits. 96MA67
385This claim was adjusted because we were notified that the provider billed for this service in error.96MA67
389This claim was adjusted to provide corrected benefits . 96MA67
38DThis service has been denied due to contract limitations. 273N435
390This claim was adjusted to provide corrected benefits. 96MA67
391This service was previously denied as a duplicate in error. 96MA67
392This claim was adjusted to provide corrected benefits. 96MA67
393This claim was adjusted to provide corrected benefits. 96MA67
394This claim was adjusted to provide corrected benefits. 96MA67
395This claim was adjusted to provide corrected benefits. 96MA67
397ITS Inclusive Grouping Number
Exp. CodeTextCARCRARC
39DBenefits for this service are limited to one time per year. 273N435
3s3Supplemental Calculation Method
40DThis date of service is after this member's termination date. 27N30
41DThis service has been paid based on group's request.
42dMcKee Executive Dental payment reimbursement
43DProcessing of this claim is suspended awaiting information from the provider.163N686
44DThis charge exceeds the maximum allowable under this member's contract.45
46DProcessing of this procedure is suspended awaiting information from this member's medical or other carrier's policy.168
47DBenefits for adult orthodontics are only payable for TMJ diagnosis. 96N569
48DBenefits for this service are limited to one time per forty-eight month period.273N435
500Submitting IPA is not related to member's IPA
501Capitated entity charge amount equal 0.00
502Prudent Layperson Override
503Delegated Claim Entity Override
504Capitation Indicator
505Capitation Fund
506Risk Indicator
507Delegated UM Entity Override
508Capitation Deduct
Exp. CodeTextCARCRARC
509Opt out override
50DBenefits for this service are limited to three times per twelve-month period.273N435
510Service Area Override
511Reimbursable allowable amount
51DGrace period for plan limits. 45
54DBenefits for this service are limited to one time per calendar year. 273N435
55DBenefits for this service are limited to once per lifetime. 273N435
56DBenefits for this service are limited to four times per calendar year. 273N435
57DBenefits for this service are limited to one time per three-year period.96N130
57dBenefits for this service are limited to one time per three calendar year period.273N435
58DPlease submit a copy of the Explanation of Benefits from this member's other insurance carrier.22N4
59DBenefits for this service are limited to one time per five-year period.273N435
60DThe combination of x-ray charges submitted on this claim should not exceed the cost of a full mouth series.169
61DThis allowance is based on a less costly procedure. The disallowed amount will be the patient's responsibility.169
61dThis procedure is non covered. An alternate standard procedure has been used to price the allowed.169
62DThe combination of x-ray charges submitted on this claim should not exceed the cost of a full mouth series.169
63DBenefits for crowns are available only when the tooth cannot be restored by any other material.96M25
704This service needs to be resubmitted using current American Dental Association procedure codes.
82DThis member or dependent is not eligible for dental benefits.
Exp. CodeTextCARCRARC
83DThis member is not eligible for dental benefits. 96N216
84DThis member is not eligible for dental benefits. 96N216
85DThis patient has met his or her annual or lifetime maximum benefits. 119N587
89DThis dental claim was processed in error.
90DThis member's contract does not allow for crown coverage. An allowance has been made for a stainless steel crown.169
95DTemporary partials are only covered for the anterior fronth teeth. 96N130
97DThis charge is considered part of the total cost. Please do not bill separately.169
98DThis dental claim was processed in error. B11N216
4s4Change Secondary Service Rule
5s5Bypass Secondary Plan Limits
6s6Change Secondary Allow per Unit
8s8Change Secondary Disallow Amount
A01This provider is not eligible under this member's coverage. 170N348 AB0Call 1-877-258-9455 for claim detail if needed. AD3This is a subrogation adjustment. It will not affect previously assigned patient liability.215 AD4This is the disallowed amount prior to subrogation adjustment. 215MA67 ADPThis amount was previously paid to the wrong payee. A corrected payment has been made.96MA67ADTThis is an adjustment of a previously processed claim due to a BCBST change to the provider assignment.96MA67
ADXThis claim was adjusted due to a change in provider information. 96MA67Exp. CodeTextCARCRARC
AUTBenefits cannot be provided for this service because the required authorization is not on file.197
AZPThis medication is to be dispensed by CVS Specialty at 1-888-265-7990. A one time exception was allowed under your medical plan.N189
B01This procedure is not covered per contract limitations. Alternate procedure pricing was used.169 B02Number of services exceeds contract limitations. An alternate procedure was used.169 B03Benefits for this service are limited to one time per seven year period.273N435B08This member's coverage does not provide benefits for TMJ (Temporomandibular Joint) Dysfunction and occlusion.96N216
B09This member's coverage does not provide benefits for implants and periodontal splinting.96N216 B10This member's coverage does not provide benefits for basic restorative dentistry.96N216 B11This member's coverage does not provide benefits for crown and prosthetic dentistry.96N216 B12This member's coverage does not provide benefits for orthodontic dentistry.96N216 B13This member's coverage does not provide benefits for gold foil restorations.96N216B14This member's coverage does not provide benefits for dental care that is elective or a special technique.96N216
B15This member's coverage does not provide benefits for replacement services due to loss or theft.96N216
B16This member's coverage does not provide benefits for desensitizing teeth.96N216 B17This service is primarily considered medical. Please file with this member's medical policy.168 B18This member's coverage does not provide benefits for adult orthodontics.96N216B19This member's coverage does not provide benefits for prescribed drugs and other medications.96N216
B20This member's coverage does not provide benefits for congenital, cosmetic or aesthetic services.96N216
B21This member's coverage only allows for sealants on the occlusal biting surface of a tooth.96N216Exp. CodeTextCARCRARC
B22This service is primarily considered medical. Please file with this member's medical policy.168 B23This provider is not eligible under this member's coverage. 185 B24This patient has met his or her annual or lifetime maximum benefits. 119N587 B25Benefits for this service have a twelve-month waiting period. 273N435 B26Benefits for this service have a twenty-four month waiting period. 273N435 B27Benefits for this service have a ninety-day waiting period. 179 B28This service is not covered when performed on the same day as a related procedure.273N435B29Benefits cannot be provided for a prosthetic device that replaces one or more teeth that were missing prior to the policy effective date.96N130
B30This service is not covered unless specific services are performed in conjunction with or prior to this service.96N130
B31This charge exceeds the maximum allowable under this member's coverage.45B32This service is not covered when performed within 90 days of another active surgical or non-surgical procedure.273N435
B33Benefits cannot be provided until we receive information about this member's eligibility.252N375 B34Benefits for this service are limited to one time per ten year period. B35Benefits payable for this member's orthodontic treatment has been provided.96N130 B36This patient has met his or her dental quarterly maximum benefits. 119N640 B37Benefits for this service are limited to four times per twelve-month period.273N435B51This service does not meet BlueCross BlueShield of Tennessee clinical criteria and will not be considered for payment.96N130
B52Recementing or repairs cannot be billed separately if done within twelve months of the initial placement procedure.273N435
B53A deleted procedure code was filed. This code was replaced with a current procedure code.181M20Exp. CodeTextCARCRARC
B54Recementing or repairs cannot be billed separately if done within six months of the initial placement procedure.273N435
B59This service is considered part of the primary procedure. Please do not bill separately.97N19 B61The servicing provider has billed this claim under the incorrect patient.96N10 B62This claim must be filed by the provider who actually rendered the service.96N32 B63This claim was adjusted because it was previously processed under a different patient.B13B64This charge was adjusted because we were notified that the provider billed for this service in error.96N10
B65This claim was paid to the wrong payee. 96N10
CBMThis member's primary insurance carrier already paid this amount. 23 CDDThis claim is a duplicate of a previously submitted claim for this member.18N522 CG0This service falls into a category that is not covered under this member's dental plan.96N216 CG1This service falls into a category that is not covered under this member's dental plan.96N216 CG2This service falls into a category that is not covered under this member's dental plan.96N216 CG3This service falls into a category that is not covered under this member's dental plan.96N216 CG4This service falls into a category that is not covered under this member's dental plan.96N216 CG5This service falls into a category that is not covered under this member's dental plan.96N216CM1This charge exceeds the previous carrier's allowed amount. Provider has agreed not to bill the patient for this amount.45
CM2The provider has agreed to accept the amount allowed under this member's contract for this service.131
CCCThe payment for this service is to reimburse the provider for patient care coordination.24M112CMSThe provider has agreed to accept the amount allowed under this member's contract for this service.131
Exp. CodeTextCARCRARC
CO1This payment was secondary to primary benefits provided by this member's other health insurance.23
CO2This amount includes the benefits provided by this member's other insurance carrier.23COBBenefits cannot be provided until we receive previously requested information concerning this member's other insurance.252N686
COSThis procedure is not eligible for benefits under this member's coverage because it was performed for cosmetic purposes.96N383
CPYThe original Copay amount has been reduced to a percentage of the allowable amountCRThis member's coverage under this plan was not in effect on the date this service was provided.27N30
CRTCREDIT-ADJUSTMENT-OVERPAYMENT TO BE DEDUCTED FROM PAID AMOUNT. Message appears on RA when auto deduct of overpayment.
CVXCoverage Exclusion 96N30
D01The dental allowable amount was increased. 45
D02The dental allowable amount was decreased. 45
D11The dental allowable amount per unit was increased. 45 D12The dental allowable amount per unit was decreased. 45D13The dental allowable units were increased. 45
D14The dental allowable units were decreased. 45
D15This is the dental disallowed amount. 96N130
D21Please submit the date orthodontic treatment started. D22Please submit accompanying x-rays for this dental procedure. 16M129DA0This dental claim is being adjusted since we have been notified that the provider billed for this service in error.96MA67
DA1This claim was previously paid to the wrong provider. A payment has been made to the correct provider.96MA67
Exp. CodeTextCARCRARC
DA2This claim was previously processed correctly under another ID number or patient's name. No additional payment is due.96MA67
DA3This disallowed amount is the ortho extended treatment and has been moved to another claim.172DA4This is an adjustment to a previous dental claim that paid to the subscriber but should have paid to the provider.96MA67
DA6A dental adjustment is in process for this claim, which will be reprocessed on a future date.96MA67
DA7This is an adjustment to a previously paid dental claim. The payable amount is less than the amount originally paid.96MA67
DA8This is money reimbursed due to another party's payment. Refer to Patient Owes column for any liability charges.215
DA9This dental claim was previously processed with an incorrect date of service.96MA67DACOther insurance information has been received and this member's records updated. This claim has been adjusted.96MA67
DADFull or partial dental benefits were denied in error. 96MA67DALThis is a dental adjustment. The provider was corrected and or subscriber payment liability.96MA67
DAPThe originally submitted procedure was replaced due to benefit plan restrictions.169 DB0This dental claim has been adjusted due to an incorrect tooth and or surface.96MA67 DB1This dental claim was adjusted due to an incorrect procedure code. 96MA67 DB2This claim was denied for an Explanation of Benefits. DB3This claim paid secondary to another insurance carrier. DB4This dental claim was denied requesting additional information from the provider. DB5A dental adjustment has been completed and has resulted in a statistical change.96MA67 DB6This claim was adjusted because the member's eligibility has been updated.96MA67DCGOverride Dental Category
Exp. CodeTextCARCRARC
DENThis dental service is not eligible for benefits under this member's coverage.96N216DG2The allowable is a discounted DRG amount. 45
DGEOverride Age Limitation
DISThis charge exceeds the maximum allowable under this member's coverage.45DMDThis oral surgery service does not meet the requirements of this member's program for coverage.96N216
DOPWe are deducting this amount because of an overpayment on a previous claim.172 DP0This patient's age is not within the normal range established for this dental procedure.96N130 DP1This dental procedure is not a covered service for this tooth/teeth numbers.96N130DP2The charge or number of occurrences this procedure was performed has exceeded the contract limits.273N435
DP3The charge or number of occurrences this procedure was performed has exceeded the contract limits.273N435
DP4The charge or number of occurrences this procedure was performed has exceeded the contract limits.273N435
DP5The number of occurrences this procedure was performed has exceeded the contract limits.273N435DPXYour group's contract requires a period of membership before benefits are available for this service.51N607
DRCThe dental runout time limit has been exceeded. 29 DREThis claim is prior to effective date of the coverage. 26N30 DRQThis date of service is after the termination of coverage. 27N30DRTTimely filing has been exceeded. 29
DSRYour claim has been received and is currently under special review. 216DUPDuplicate of previous claim. If corrected billing, please resubmit according to billing guidelines.18N522
Exp. CodeTextCARCRARC
DWPOverride Dental Category Waiting Period
ECTECT single or multiple is not a billable service for this discipline level.185N684EMRThis amount was previously reimbursed and is not included in the Executive Medical Reimbursement.96M86
EMrThis amount is for Executive Medical Reimbursement. 96M86EOBPlease submit a copy of the Explanation of Benefits from this member's other insurance carrier.22MA04
EXCThis claim was paid as an exception. Future claims without a referral from the member's PCP will be denied.45N189
FTPFamily therapy is a non-covered service. 96N30
FYIRECALCULATED PAYMENT - EXCLUDED FROM AMOUNT PAID. (Message appears on RA when auto deduct of overpayment.)
G44This check amount is the outstanding balance (minus deductible and coinsurance) that the provider may bill.96N30
GARExecution Of Garnishment
GLBThis claim is disallowed because it is included in the global case payment.97N525 GNSThe provider must file this claim with Magellan, P.O. BOX 5190, Columbia, MD 21046.109N418GRPThe member's group has already paid for this claim. We are reimbursing the member's group by manual check.96N30
HLDThere is a hold on payment of this claim. 96N30 HM0Call 1-877-258-9455 for claim detail if needed. HRAThis amount was paid from the member's Health Reimbursement Account. 187 INFMedical records have been requested from the provider. 252M127 INHThis charge exceeds the maximum allowable under this member's coverage.45 INVThis procedure is considered investigative and is not covered under this member's plan.55N623Exp. CodeTextCARCRARC
IPMIndividual Psychotherapy with Medical Management is non-covered. 96N30IRSExecution of IRS Levy
IS1This is the State surcharge amount which is payable to the provider. 96N30ISSThis service is not covered per the information submitted. The provider should verify coding and resubmit if incorrect.16MA39
ITABenefits cannot be provided for this service because the required authorization is not on file.197
ITDThe provider must file this claim with his or her local BlueCross BlueShield plan for processing.109N418
LABThis laboratory charge was already paid to the lab that performed the service. The patient should not be billed.24
LB1This laboratory charge was already paid to this member's physician. The patient should not be billed.24
LETBenefits cannot be provided for this service. We are sending the member additional correspondence to explain.96N179
LOVThis charge exceeds the maximum allowed under this member's coverage.45MADThis portion of your Medicare Part A deductible is not covered under your supplemental policy.96N30
MARCall 1-877-258-9455 for claim detail if needed.MATA portion of this claim is denied because this member was not eligible for benefits for the entire term of the pregnancy.179
MBDThis member's plan does not cover the Medicare Part B deductible. 96N30 MCCWe cannot pay benefits until this member's out-of-pocket amount has been satisfied.96N30MCDThis charge was denied by Medicare and is not covered on this plan. The provider can bill the patient.96N30
MDCThis amount exceeds the reimbursement due to Medicaid. 45MEDPlease submit a copy of the Medicare Explanation of Benefits (EOB) so we can determine benefits.22MA04
MLNThe provider must submit the primary diagnosis. 11N657Exp. CodeTextCARCRARC
MPFMedicare paid this service in full. 23
MPfMedicare paid this service in full. 23
MR1Medicare denied this charge and the provider cannot bill you for it. 45MR3The provider agreed to accept the amount allowed under this member's contract for this service.131
MSDThe allowable amount for this service has been reduced according to multiple same day surgery guidelines.59N644
MSPThis payment is secondary to benefits provided by Medicare. 23 MTNThis service was prepaid by Middle Tennessee IPA. 24MXCThe provider's charge exceeds the amount allowed by Medicare. The member is not responsible for this amount.45
MdsThis is a non-participating facility. The Medicare Part A deductible/coinsurance is not covered under this member's plan.242M115
MrxThese benefits are reduced because a non-participating pharmacy was used.242N01This procedure is considered subset or redundant to the primary procedure and is limited by this member's plan.97M80
N02The procedure is considered subset or redundant to the primary procedure and is limited by this member's plan.97M80
N03This procedure is secondary to the primary procedure and is limited by this member's plan.97M80N04This service is a part of the original surgical procedure and is limited by this member's plan.97M144
N05This service is not covered when performed on the same day as a surgical procedure.97N20 N06This procedure does not normally require the services of an assistant surgeon.54N646N09This procedure is not eligible for benefits under this member's coverage because it was performed for cosmetic purposes.96N383
N10This procedure is considered investigative and is not a covered service under this member's plan.55N623
N11This procedure is no longer considered clinically effective and is not eligible for benefits.56N623
Exp. CodeTextCARCRARC
N13This is a deleted/invalid code or modifier for this date of service. The provider should submit the proper code.182N657
N14This service is not covered for this member. The provider should submit the proper code or medical documentation.16MA39
N15This service is not normally performed for members in this age range. 6N129 N16This service is not normally performed for members in this age range. 6N129 N17This service is not covered when performed in this setting. 96N428 N19This service is not covered when performed for the reported diagnosis. 11N657 N25The charge for this service has been combined with the primary procedure.234M15N26This service is a part of the original surgical procedure and is limited by this member's plan.97M144
N29This procedure is redundant to the primary procedure and is limited by this member's plan.97M80 N30The maximum amount allowable for this equipment has been reached. 45 NBThese benefits are for an eligible newborn who has not been added to this subscriber's plan.96N30NCCThis member's coverage excludes benefits for the condition for which this service was rendered.96N216
NCPBenefits for this service are excluded under this member's plan. 96N216NECBenefits cannot be provided for services that have been determined not to be medically necessary.50N130
NERBenefits cannot be provided for services not considered a medical emergency.40 NRTThis is a non-contracted room type. The room type is disallowed. 45 O25The charge for this service has been combined with the primary procedure.169 OASThis service is not normally covered for members in this age range. 6N129 OJIThese services are related to an on-the-job injury. 19Exp. CodeTextCARCRARC
OOAThis claim was filed by an out of area dental provider.OPCOverride PCA Disallow
OTCDrugs that can be purchased without a prescription are not an eligible expense.96N30 OTcDrugs that can be purchased without a prescription are not an eligible expense.96N30 OUTThese benefits have been reduced because a non-participating provider was used.242N130 OVPWe are deducting this amount because of an overpayment on a previous claim.96N10 P50Present On Admission indicator required but is not valid. P59There are one or more edits present that cause the whole claim to be rejected.96N56P60There are one or more edits present that cause the whole claim to be returned to the provider.96N56
P61There are one or more edits present that cause the whole claim to be rejected.96N56 P62There are one or more edits present that cause the whole claim to be denied.96N56 PAAThis charge exceeds the maximum allowable under this member's coverage.45 PACThis charge exceeds the maximum allowable under this member's coverage.45PAHAPC Rate
PAIThis charge exceeds the maximum allowable under this member's coverage.45 PAKThis charge exceeds the maximum allowable under this member's coverage.45 PALThis charge exceeds the maximum allowable under this member's coverage.45 PAPThis charge exceeds the maximum allowable under this member's coverage.45 PARThis charge exceeds the maximum allowable under this member's coverage.45Exp. CodeTextCARCRARC
PCDThis charge exceeds the maximum allowable under this member's coverage.45PCPThis member has not chosen a PCP or has selected a PCP who is not participating in the plan.242N130
PCSThis prescription requires prior authorization through your pharmacy. 197 PDAThis charge has been reduced based on a discount arrangement with this provider.45 PDCThis charge has been reduced based on a discount arrangement with this provider.45 PDDThis charge has been reduced based on a discount arrangement with the provider of service.45 PDPThis charge has been reduced based on a discount arrangement with this provider.45 PE0This charge exceeds the maximum allowable for this service. 45 PEDRoutine nursery or pediatric care of a newborn is not eligible for benefits.96N30 PENBenefits for this service have been reduced due to lack of compliance with plan requirements.197 PEOThis charge exceeds the maximum allowable under this member's coverage.45 PEXThis charge exceeds the maximum allowable under this member's coverage.45 PFCThis charge exceeds the maximum allowable under this member's coverage.45 PFSThis charge exceeds the maximum allowable under this member's coverage.45 PFUThis charge exceeds the maximum allowable under this member's coverage.45 PFVThis charge exceeds the maximum allowable under this member's coverage.45 PFWThis charge exceeds the maximum allowable under this member's coverage.45 PGAThis charge is not reimbursed according to your DRG contract. Please see the provider manual.45 PGDThis charge exceeds the maximum allowable under this member's coverage.45