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