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