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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
K
T
N
I
Y
B
I
H
D
S
Y
W
C
K
K
B
I
A
R
U
I
R
S
P
C
U
S
K
O
B
D
S
E
N
K
B
J
E
Q
S
Z
Q
O
D
W
F
A
K
G
C
O
B
Y
N
I
E
U
J
R
R
Q
V
E
V
G
V
A
P
Z
I
A
U
V
E
U
A
O
L
U
B
J
H
L
T
D
L
I
R
M
E
D
I
C
A
R
E
B
D
P
R
O
C
E
D
U
R
E
L
P
J
W
R
R
E
I
P
L
A
C
E
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