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