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