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