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