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