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