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