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