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