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