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Miscellaneous: Claims Adjustments
Claims
Claims Adjustments
Claims
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CHARGES
COB
DATE
DIAGNOSIS
MEDICARE
PLACE
PROCEDURE
PROVIDER
SUBSCRIBER
F
E
U
W
X
O
C
N
O
S
S
N
R
E
R
U
D
E
C
O
R
P
R
D
E
R
A
C
I
D
E
M
R
M
O
I
T
S
Z
P
B
Q
S
O
U
B
E
A
I
E
I
T
K
V
V
N
H
E
I
G
R
G
R
K
M
I
D
R
Y
C
C
N
G
R
X
K
D
O
U
V
S
A
O
O
G
A
T
E
X
L
B
V
N
L
B
S
C
H
R
Q
U
B
W
S
E
P
Y
I
T
C
S
Y
R
Z
D
V
X
A
T
S
F
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