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