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