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