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