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