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Miscellaneous: Claims Adjustments
Claims
Claims Adjustments
Claims
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CHARGES
COB
DATE
DIAGNOSIS
MEDICARE
PLACE
PROCEDURE
PROVIDER
SUBSCRIBER
Y
U
P
D
L
Y
X
E
K
V
S
J
X
Z
G
D
N
R
S
R
U
S
S
E
I
W
E
A
E
C
B
I
G
W
R
L
T
C
G
H
S
S
A
A
K
U
A
I
R
T
C
O
P
X
J
O
D
D
A
C
R
N
L
D
R
T
K
E
H
Z
I
G
A
R
Y
C
O
M
C
O
B
A
C
W
O
I
S
K
C
O
E
I
E
V
F
C
E
A
F
U
R
D
A
F
K
W
O
P
X
E
S
P
R
O
V
I
D
E
R
Z
A
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