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