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