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