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