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