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