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