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