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