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