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