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