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