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