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