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