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