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