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