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