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