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