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