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