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