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