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