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