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