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