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