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