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