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