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