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