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