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