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