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