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