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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
A
C
C
F
Z
W
H
E
J
Y
S
U
D
I
A
G
N
O
S
I
S
U
L
B
R
P
N
B
O
V
C
F
E
S
L
S
E
O
W
K
A
Y
M
V
R
E
W
C
D
A
H
Y
R
Z
N
C
A
G
E
R
I
J
G
Q
E
T
K
E
C
R
X
I
V
O
Q
C
O
D
D
T
I
A
T
B
O
T
A
X
S
G
V
A
D
H
E
E
R
L
S
J
E
R
U
D
E
C
O
R
P
A
I
H
S
Q
W
U
M
U
P
G
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