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