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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
C
R
E
D
I
V
O
R
P
R
S
P
H
P
L
A
C
E
M
R
Q
E
I
P
A
W
S
J
I
E
O
Q
A
H
S
J
R
V
E
B
D
C
K
A
P
Z
O
X
G
I
Z
I
E
W
C
K
W
J
N
R
E
N
C
D
J
N
M
B
O
C
G
B
S
A
U
L
H
S
C
S
Q
H
A
T
R
R
Y
L
H
B
U
D
V
E
I
E
E
K
D
U
D
S
L
A
P
X
D
T
F
S
I
G
V
R
Q
A
Y
L
T
E
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