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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
U
R
E
D
I
V
O
R
P
Y
T
M
I
A
A
C
G
Y
M
R
D
H
K
T
J
G
B
T
O
E
O
I
N
E
E
Z
L
X
J
B
D
C
A
S
L
C
S
F
E
I
Z
I
E
G
X
Z
S
E
G
R
A
H
C
D
N
K
D
B
O
C
O
L
E
A
U
O
V
K
I
S
Y
Z
C
Z
R
R
S
M
E
B
P
L
A
C
E
E
E
I
U
U
V
U
S
G
B
V
I
U
S
S
B
I
P
W
M
W
Q
B
D
J
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