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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
N
L
I
N
G
G
E
U
S
L
Q
U
L
I
R
F
Q
O
I
H
E
X
W
B
Q
W
O
B
S
T
R
R
Y
C
N
S
K
O
O
C
O
B
E
P
N
X
A
C
N
F
D
S
Q
D
L
B
L
C
G
R
K
X
E
D
I
A
Z
E
A
I
H
I
A
L
G
V
C
F
I
T
K
D
J
B
D
H
O
E
D
E
R
A
C
I
D
E
M
R
E
A
E
R
U
D
E
C
O
R
P
R
X
W
S
E
G
R
A
H
C
R
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