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