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