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