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