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