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