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