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