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