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