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