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