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