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