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