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