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