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