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