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