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