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