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