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