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