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