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