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