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