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