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