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