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