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