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