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