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