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