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