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