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