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