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