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