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