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