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