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