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