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