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