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