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