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