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