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