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