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