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