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