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