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