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