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Miscellaneous: Claims Adjustments
Claims
Claims Adjustments
Claims
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CHARGES
COB
DATE
DIAGNOSIS
MEDICARE
PLACE
PROCEDURE
PROVIDER
SUBSCRIBER
E
P
R
O
V
I
D
E
R
D
R
C
R
M
S
S
X
M
Q
K
M
B
A
O
E
F
G
M
B
G
P
D
U
L
C
D
B
H
J
V
M
I
P
T
P
E
I
T
I
Y
B
A
B
B
F
U
D
C
H
A
R
G
E
S
Y
J
P
U
A
G
N
N
C
U
J
W
Z
I
R
R
T
O
G
O
S
F
H
I
E
E
E
S
E
X
B
W
B
O
E
I
X
I
D
W
M
V
Y
Z
U
N
G
S
O
J
D
I
I
Z
M
T
S
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