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