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