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