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