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Miscellaneous: Claims Adjustments
Claims
Claims Adjustments
Claims
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CHARGES
COB
DATE
DIAGNOSIS
MEDICARE
PLACE
PROCEDURE
PROVIDER
SUBSCRIBER
D
N
N
X
G
B
Y
D
I
J
S
Z
Q
G
Z
F
H
V
B
Z
U
S
H
H
Y
G
B
Q
R
R
B
E
M
P
B
F
H
I
O
E
S
G
R
B
E
K
W
A
Q
D
C
R
B
A
W
E
F
S
F
I
R
A
W
W
C
S
C
I
M
V
I
H
U
X
E
I
D
A
U
O
B
C
C
F
T
V
D
V
L
R
E
M
L
J
A
K
G
E
Q
P
R
O
C
E
D
U
R
E
M
H
E
D
I
A
G
N
O
S
I
S
J
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