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