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