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