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