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