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