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