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