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