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