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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
I
D
W
Z
E
V
G
R
W
S
Y
K
G
Z
I
J
T
B
E
U
G
R
W
Q
R
L
S
M
Z
B
V
D
E
C
G
L
T
E
J
S
R
W
I
D
P
W
R
N
G
C
O
B
V
A
I
W
O
T
S
R
R
R
Q
M
G
V
R
A
W
I
A
J
A
E
K
N
O
Z
J
B
O
H
L
T
S
U
O
R
M
E
D
I
C
A
R
E
X
S
P
R
O
C
E
D
U
R
E
O
I
P
E
P
L
A
C
E
V
K
B
S
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