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