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