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