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