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