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