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