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