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