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