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