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