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