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