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