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