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