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