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