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