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