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