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