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