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