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