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