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