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