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