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