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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
B
Q
K
T
A
D
M
S
N
P
R
O
C
E
D
U
R
E
E
E
L
R
E
B
F
A
S
S
D
G
D
A
U
O
B
Z
T
P
K
I
R
I
C
V
D
V
I
E
B
V
C
A
A
E
G
M
W
I
R
O
X
A
H
G
M
M
L
P
K
D
C
K
R
C
N
N
U
U
V
J
P
E
S
E
T
O
J
R
N
G
N
E
R
R
B
D
S
B
K
A
G
G
U
W
N
A
U
I
G
T
P
I
P
B
P
L
J
N
S
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