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