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