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