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