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