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