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