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