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