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