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