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