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