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