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