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