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