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