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