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