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