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