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