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