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