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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
L
O
L
Y
S
G
M
G
W
P
E
Q
E
R
U
D
E
C
O
R
P
F
A
L
X
A
D
H
N
E
R
L
U
I
P
T
I
A
D
B
O
Y
A
H
W
E
C
R
E
I
V
P
M
C
I
I
A
G
M
R
I
B
M
X
E
Q
R
E
F
C
D
B
D
P
M
X
E
S
B
S
E
O
Z
M
K
L
Q
X
U
B
R
U
F
B
J
J
V
C
S
U
T
S
E
N
U
Y
L
X
M
S
C
S
I
S
O
N
G
A
I
D
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