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