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