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