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