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