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