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Miscellaneous: Claims Adjustments
Claims
Claims Adjustments
Claims
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CHARGES
COB
DATE
DIAGNOSIS
MEDICARE
PLACE
PROCEDURE
PROVIDER
SUBSCRIBER
A
M
X
W
P
T
X
Q
Y
C
S
P
F
L
O
J
M
Q
H
N
U
E
C
B
H
Y
B
X
C
R
B
E
R
L
J
Z
E
P
O
E
S
S
S
A
V
A
F
Q
D
D
C
O
E
B
C
E
J
R
F
I
R
X
G
K
P
I
C
W
F
V
I
H
R
O
E
X
D
A
J
O
B
R
A
S
T
Y
E
E
L
R
E
P
H
G
A
P
B
X
M
P
R
O
C
E
D
U
R
E
V
B
D
I
A
G
N
O
S
I
S
T
F
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