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