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