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