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