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