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