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