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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
I
S
O
N
G
A
I
D
T
K
Q
B
E
R
U
D
E
C
O
R
P
M
E
D
I
C
A
R
E
E
R
L
B
S
L
E
A
T
N
B
O
M
A
E
D
R
V
J
E
I
V
C
P
C
N
K
G
F
F
R
I
H
G
L
E
G
U
B
O
C
D
A
L
W
M
Y
P
A
T
S
E
R
O
I
T
Q
J
W
G
B
R
G
D
F
Z
M
C
G
M
U
B
E
L
E
B
E
Y
F
Z
S
H
S
X
R
G
T
M
W
O
B
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