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Miscellaneous: Claims Adjustments
Claims
Claims Adjustments
Claims
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CHARGES
COB
DATE
DIAGNOSIS
MEDICARE
PLACE
PROCEDURE
PROVIDER
SUBSCRIBER
I
R
Y
Y
P
L
Q
W
U
J
S
S
C
P
G
K
F
N
U
Z
U
D
I
H
B
V
B
K
K
R
B
D
I
D
A
A
T
L
O
E
S
E
C
A
P
R
I
M
I
D
C
N
R
Y
G
E
G
Q
D
I
R
Y
U
A
B
N
C
E
A
V
I
E
J
K
C
Q
O
A
S
O
B
I
T
N
R
I
O
S
L
R
E
E
C
A
J
C
D
P
I
P
R
O
C
E
D
U
R
E
N
S
M
T
U
J
T
Y
X
S
M
N
G
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