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