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