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