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