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