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