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