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