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