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