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