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