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