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