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