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