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