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