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