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