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