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