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