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