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