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