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