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