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