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