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