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