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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
I
D
I
A
G
N
O
S
I
S
X
U
T
G
E
C
A
G
O
O
S
A
C
B
F
Q
T
E
R
E
E
G
W
G
T
S
R
N
Y
T
R
R
E
P
C
N
A
C
O
B
V
A
U
C
X
U
S
E
G
R
A
H
C
D
A
R
M
P
S
L
R
I
J
I
E
L
T
R
Y
D
U
A
Z
B
D
C
P
D
O
P
N
A
I
D
W
E
O
S
W
C
N
T
O
W
N
N
M
R
Z
O
M
R
E
D
I
V
O
R
P
J
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