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