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