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