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Miscellaneous: Claims Adjustments
Claims
Claims Adjustments
Claims
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CHARGES
COB
DATE
DIAGNOSIS
MEDICARE
PLACE
PROCEDURE
PROVIDER
SUBSCRIBER
X
S
S
F
B
G
D
G
L
K
S
A
V
C
L
M
V
R
S
J
U
L
R
O
G
Y
Y
S
B
T
B
Z
D
E
E
Y
X
Z
E
O
S
N
G
I
D
Q
X
E
U
G
C
N
L
P
A
I
R
G
O
F
R
N
G
Y
Z
G
V
U
S
U
I
A
U
R
E
G
N
O
N
A
B
G
H
B
T
X
R
O
R
M
E
D
I
C
A
R
E
G
S
P
R
O
C
E
D
U
R
E
Y
I
P
L
A
C
E
U
Z
B
X
C
S
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