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