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