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