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