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