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