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