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