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