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