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