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