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