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