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