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