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