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