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