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