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