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