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