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