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