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