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