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