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