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