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