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